Neuralgia is a painful disorder
of the nerves. Under the general heading of neuralgia
are trigeminal neuralgia (TN), atypical facial pain,
and postherpetic neuralgia (caused by shingles or
herpes). Neuralgia is also involved in disorders such
as sciatica and Brachial Plexopathy with Neuropathia.
In the case of trigeminal neuralgia the affected
nerves are responsible for sensing touch, temperature,
sensation, and pressure sensation in the facial
area from the jaw to the forehead. The disorder generally
causes short episodes of excruciating pain, usually
for less than two minutes and on only one side of
the face. The pain can be described in a variety
of ways such as "stabbing," "sharp,"
"like lightning," "burning," and
even "itchy". In the atypical form of
TN, the pain can also present as severe or merely
aching and last for extended periods. The pain
associated with TN is recognized as one of the
most excruciating pains that can be experienced.
Simple stimuli such as eating, talking, washing
the face, or any light touch or sensation can trigger
an attack (even the sensation of a gentle breeze).
The attacks can occur in clusters or as an isolated
attack. Some patients will have a muscle spasm which
led to the original term for TN of "tic douloureux"
("tic", meaning 'spasm', and "douloureux",
meaning 'painful', in French).
Neuralgia is a form of chronic pain and can be extremely
difficult to diagnose. Patients usually show no physical
abnormalities, and with the attacks generally lasting
a very short time, it can be difficult to reach a
doctor before the attack is over. Postherpetic neuralgia
is the easiest to diagnose because it follows an obvious
cause (shingles).
Neuralgia is rare, especially in those under 30. Women
are more likely to be affected than men, and those
over 50 are at the greatest risk. In some cases, multiple
sclerosis is related to nerve damage, causing the
pain, so doctors will likely ask about family history
to help diagnose. Nothing unusual can be seen in brain
scans, so diagnosis is usually based on the description
of the symptoms.
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