Neuralgias
Specialized treatment for nerve pain syndromes
Understanding Neuralgias
Neuralgia refers to sharp, shocking, or burning pain that follows the path of a nerve and is caused by nerve irritation or damage. Unlike nociceptive pain, neuralgic pain is neuropathic in nature, arising from dysfunction of the nervous system itself. Neuralgias can affect any nerve but most commonly involve cranial nerves or peripheral nerves.
Common types include trigeminal neuralgia, glossopharyngeal neuralgia, occipital neuralgia, and postherpetic neuralgia. The pathophysiology often involves demyelination, nerve compression, or damage from various causes. Neuralgias can be severely debilitating, with intense pain significantly impacting quality of life.
Common Causes
Nerve Compression
Blood vessels, tumors, or bone structures pressing on nerves causing irritation
Nerve Damage
Trauma, surgery, or dental procedures injuring peripheral nerves
Viral Infections
Herpes zoster (shingles) causing postherpetic neuralgia through nerve damage
Demyelination
Loss of protective nerve covering in conditions like multiple sclerosis
Metabolic Disorders
Diabetes or other conditions causing nerve dysfunction
Idiopathic
Many cases have no identifiable cause despite thorough investigation
Symptoms
Sudden, severe, electric shock-like pain
Pain triggered by light touch or cold exposure
Brief pain episodes lasting seconds to minutes
Burning or aching pain between episodes
Specific trigger zones precipitating pain
Unilateral pain affecting one side
Muscle spasms accompanying pain episodes
Anxiety and fear of triggering attacks
Advanced Treatment Options
Microvascular Decompression
Neurosurgical procedure with 80-90% initial success rate for trigeminal neuralgia
Gamma Knife Radiosurgery
Stereotactic radiation targeting nerve roots for patients unsuitable for open surgery
Percutaneous Procedures
Radiofrequency thermocoagulation or glycerol injection to damage pain fibers
Peripheral Nerve Blocks
Diagnostic and therapeutic injections of local anesthetics and steroids
Pulsed Radiofrequency
Non-destructive nerve modulation preserving nerve function
Peripheral Nerve Stimulation
Implanted electrodes delivering electrical pulses to modulate pain signals
Neurectomy
Surgical cutting of affected nerve branches for refractory cases
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