[Craniofacial neuralgias]
- PMID: 18710080
[Craniofacial neuralgias]
Abstract
Craniofacial neuralgias are characterized by sudden paroxysmal pain along the distribution of one or more of the cranial or upper cervical spinal nerves. The most significant neuralgia of the craniofacial region is trigeminal neuralgia, while geniculate neuralgia, glossopharyngeal neuralgia and occipital neuralgia are less common. Trigeminal neuralgia may be primary or secondary. Idiopathic trigeminal neuralgia or tic douloureux has been recognized for centuries as an extremely painful disorder most commonly involving the maxillary nerve. Recurrent lancinating, shocklike unilateral pain lasting for seconds to minutes is provoked by non noxious stimulation of the skin at specific sites around the face and less frequently by movement of the tongue. The trigger zones are usually within the same dermatome as the painful sensation. After each episode, there is usually a refractive period during which stimulation of the trigger zone will not induce pain. Idiopathic trigeminal neuralgia occurs somewhat more frequently in women and usually begins in individuals 50 to 70 years of age. There is no pain between attacks, and the frequency of painful episodes can range from several per day to only a few per year. With time, the features may become more atypical, with greater areas of more enduring and dull pain and occasionally bilateral pain, rarely on both sides simultaneously. No sensory or reflex deficit is detectable by routine neurologic testing. Diagnostic local anesthetic blocks will identify the specific nerves involved and the trigger point distribution. Neurologic and neuroradiologic examination is advised in all cases to rule out diseases such as intracranical tumors, vascular malformations or multiple sclerosis.
Similar articles
-
Symptomatic cranial neuralgias in multiple sclerosis: clinical features and treatment.Clin Neurol Neurosurg. 2012 Feb;114(2):101-7. doi: 10.1016/j.clineuro.2011.10.044. Epub 2011 Nov 29. Clin Neurol Neurosurg. 2012. PMID: 22130044 Review.
-
Neuropathic orofacial pain.Oral Maxillofac Surg Clin North Am. 2008 May;20(2):237-54, vii. doi: 10.1016/j.coms.2007.12.001. Oral Maxillofac Surg Clin North Am. 2008. PMID: 18343328 Review.
-
Synchronous presentation of trigeminal, glossopharyngeal and geniculate neuralgias in a single patient.Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Jun;121(6):626-8. doi: 10.1016/j.oooo.2016.02.007. Epub 2016 Feb 23. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016. PMID: 27055735
-
[A clinical approach to cranial neuralgias].Rev Neurol. 2009 Apr 1-15;48(7):365-73. Rev Neurol. 2009. PMID: 19319818 Review. Spanish.
-
[Therapy of facial pain].Dtsch Med Wochenschr. 2007 Oct;132(41):2149-52. doi: 10.1055/s-2007-985655. Dtsch Med Wochenschr. 2007. PMID: 17924296 Review. German.
Cited by
-
Ultrasound-Guided Glossopharyngeal Nerve Block at Pharyngeal Wall Level in a Patient with Carcinoma Tongue.Indian J Palliat Care. 2020 Jan-Mar;26(1):140-141. doi: 10.4103/IJPC.IJPC_132_19. Epub 2020 Jan 28. Indian J Palliat Care. 2020. PMID: 32132800 Free PMC article.
Publication types
MeSH terms
LinkOut - more resources
Medical