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Neuralgia is a state at which there is a defeat of peripheral nerves. For this disease pristupoobrazny painful feelings in a zone of an innervation of a certain nerve are characteristic. If to compare neuritis and neuralgia, then in the latter case there is no disturbance of motive function, and also sensitivity loss. Changes of structure of the affected nerve are also absent. As a rule, development of neuralgia happens generally in nerves which pass in narrow channels and openings.
Features of neuralgia
Manifestation of short paroxysms of the unilateral shooting pains of big intensity in a zone of an innervation of branches of a trifacial is characteristic of neuralgia of a trigeminal (facial) nerve. Quite often pain provokes touches to skin of a kurkovy zone (that is skin of a nose, lips, eyebrows). This disease is more characteristic of women, and, the quantity of cases of neuralgia of a facial nerve increases at persons is more senior than forty years.
The trifacial is the fifth among twelve couples of cranial nerves. On it function is put to provide sensitivity in a face. Trifacials are located on both sides of the person. Each nerve has three branches. Function of the first — to provide sensitivity of eyes, skin of a forehead and an upper eyelid; the second — sensitivity of cheeks, nostrils, a lower eyelid, an upper lip and gingiva; thirds — sensitivity of an under lip and a jaw, gingiva and number of masseters.
Neuralgia can be subdivided into two different forms of a disease: neuralgia primary (idiopathic, essential, typical) and neuralgia secondary (symptomatic).
As a rule, squeezing of a trifacial which happens owing to crossclamping by his arteries or veins of a back cranial pole is considered the reason of neuralgia of a facial nerve. The vascular loop in case of anomaly of vessels can squeeze a nerve also. Besides trifacial branches, passing through bone channels of a base of skull, compressions can undergo in them. Channels are in certain cases narrowed from the birth, also narrowing of channels often happens owing to chronic inflammations in adjacent zones (sinusitis, caries can be the cause of the similar phenomenon). In more exceptional cases the trifacial is compressed by a tumor of mostomozzhechkovy area.
As a rule, neuralgia symptoms at the person arise spontaneously, without certain reasons. In more exceptional cases attacks begin to be shown after injuries, dental care, etc. At neuralgia of a facial nerve at the patient attacks of severe, painful pains which are localized in a zone of an innervation of branches of a trifacial are periodically shown. Similar painful paroxysms can last as several seconds, and several minutes. The attack stops suddenly. Between attacks pain is not shown. As a rule, similar attacks happen to a number of vegetative manifestations. So, symptoms of neuralgia are shown by emergence of a hyperemia of the person, too strong salivation, a current of tears. There can be reflex reductions of chewing and mimic muscles. Symptoms of neuralgia are so intensive that during an attack of people it is forced to stiffen in a certain pose, in fear to move. To reduce pain during an attack often sick it is necessary to accept peculiar poses,
to hold the breath or to breathe strenuously. Sometimes area in which pain is shown the person is forced to pound, squeeze. On a human face there are several sites at which irritation by a mechanical or temperature method patients with neuralgia have painful attacks.
Pain which arises during attacks at people with an epileptiform neuralgia happen very different. As a rule, the person feels the burning, shooting pain, sometimes pain has the burning-down, pricking character, feelings of "current rushes" are shown. At some patients attacks can be shown one by one, at the same time the interval between them makes only a few minutes.
Symptoms of neuralgia disappear after the corresponding treatment, in more exceptional cases they can independently disappear. At the same time the remission period at patients with neuralgia of a facial nerve can last both several months, and several years. Method after which remission happens especially quickly is alcoholization of branches of a trifacial. However it is necessary to consider that each following alcoholization reduces remission duration, respectively, the method becomes less effective.
There is both a unilateral, and bilateral epileptiform neuralgia.
At dontogenous defeats of a trifacial painful and vegetative manifestations are strongly expressed and especially persistent. The disease of this form can proceed a long span and not disappear even on condition of a stop of the main disease process which provoked development of neuralgia.
Diagnosis of neuralgia
As a rule, at diagnosis of a disease specialists, first of all, are guided by complaints of the patient, and also results of detailed survey of the patient. To define the reason which became a basis for development of neuralgia research by means of a magnetic and resonant tomography is applied. In this case identification of signs of a multiple sclerosis, a tumor is possible. But there are many other reasons which cannot be found at the specified inspection method.
In the course of diagnosis of an epileptiform neuralgia it is important to differentiate it from a dental pleksalgiya at which pain is shown in jaws. It is also important to distinguish neuralgia from arthrosis of a temporal and mandibular joint, multiple sclerosis, etc.
Treatment of neuralgia
Each person to whom the diagnosis "epileptiform neuralgia" was made needs to realize that this disease recovers not always. But by means of a number of modern means morbidity at attacks can be facilitated considerably. First of all, at neuralgia of a facial nerve the doctor appoints to the patient anticonvulsant drugs. So, often at treatment of neuralgia drugs carbamazepine, Phenytoinum in doses which the specialist selects individually are used. To strengthen influence of an antikonvulsant, antihistaminic drugs (isopromethazine, a Dimedrol) are often used. Also in a complex of therapy use spasmolytic and vasodilating drugs. At treatment of neuralgia an effective remedy often is the physical therapy (an ionogalvanization with novocaine, pyramidon, ultrafonoforez with a hydrocortisone, diadynamic currents). To improve a trophicity of the affected nerves, at complex treatment there are drugs of B1, B12, E vitamins, and also polyvitamins. Approximately in 40% of cases patients feel effect
from a combination of different methods of treatment: reflekso-, fizio-and drug treatment.
However if complex drug treatment has no due effect, then it is necessary to apply surgical methods. Often treatment assumes carrying out a microsurgical decompression of branches of a trifacial or section of branches of a nerve proksimalny a gasserova of a node.
Also there is a number of new methods of treatment of neuralgia with use modern the technician. But at the same time also some national methods of treatment allowing to reduce degree of the shown neuralgia symptoms are still used.
Neuralgia of an occipital nerve
At neuralgia of an occipital nerve of people, first of all, complains of frequent developing of a headache in a nape. Neuralgia of an occipital nerve often arises owing to overcooling, existence at sick osteochondrosis which is shown by protrusions and hernias of intervertebral disks. Also similar state sometimes arises because of severe emotional stresses, spine injuries, a long muscle tension of static character.
Neuralgia of an occipital nerve has the following characteristic manifestations: pain is always shown pristupoobrazno, the "shooting" pain. Pains always arise in a nape, sometimes give to auricles and area around them. As a rule, pain arises on the one hand, at the same time it is difficult to person to move the head here and there. In attempts to incline the head or turn her pains can become even more intensively. From outside, where pain is shown, there can be a disturbance of sensitivity in a nape, and also near an auricle.
To diagnose neuralgia of an occipital nerve, it is necessary to pass survey at specialists: the orthopedist, the neurologist, and also, in case of need, to conduct examination in the form of a magnetic and resonant tomography. Treatment of neuralgia is carried out with use of complex medicamentous therapy at which first of all the drugs which are effectively killing pain are used. Rather notable effect is rendered also by physiotherapeutic methods of treatment of neuralgia. So, massage, remedial gymnastics, extension of a backbone, etc. is used.
Prevention of neuralgia
For prevention of neuralgia by the most important the prevention of strong overcooling of an organism, and also injuries is considered. As wider measures of prevention observance of the principles of healthy food, existence of constant exercise stresses, correct and active lifestyle at any age is important. It is important to realize the fact that at people chances to ache with neuralgia increase with age. Provocative factors it is frequent to become work, it is connected with transfer of weights, and also monotonous work at which the person stays in the same situation a long time. Often neuralgia is shown in an organism as complication of flu therefore flu, and also other viral infections it is necessary to treat carefully and correctly.
It is regularly important to patients for whom neuralgia is diagnosed to take courses of physiotherapeutic treatment and to fill a reserve of vitamins of group B in an organism.