What is a Neuralgia?
A neuralgia is a type of neuropathic (nerve illness) pain that is paroxysmal, or episodic. Trigeminal neuralgia is the most common of the neuralgias, which all have the same characteristics but occur in different locations. Glossopharyngeal, geniculate, superior laryngeal, and occipital neuralgia are other neuralgias that occur in the head and neck region.
Because a neuralgia is triggered by the stimulation of peripheral nerves, topical and local anesthetic will temporarily block the pain. During an attack, anesthetics can be used to provide rapid relief and assist in making a proper diagnosis. Longer pain relief can be achieved with oral medications in combination with cognitive behavioral therapy. In some instances, surgical care may be indicated.
An MRI of the brain is required whenever a neuralgia is present to identify potential causes of the symptoms.
Trigeminal neuralgia is characterized by severe, intense, sharp stabbing or electrical pain affecting the trigeminal nerve. The attacks of pain usually occur on one side of the face, last only seconds, and most commonly affect the area around the upper and/or lower jaw. The pain is usually triggered by movement, contact, or thermal changes, making normal daily activities such as talking, shaving, or applying cosmetics an extremely painful experience.
Glossopharyngeal neuralgia affects the throat, ear, tongue, and teeth on one side and is triggered by normal activities such as coughing or swallowing.
Geniculate or Nervus Intermedius neuralgia affects the sensory portion of the facial nerve with trigger points in and around the ear. Once triggered, the pain is felt in the eardrum, the ear canal and the outer portion of the ear.
Superior Laryngeal neuralgia involves a branch of the vagus nerve and can be difficult to distinguish from glossopharyngeal neuralgia because it is also triggered by coughing and swallowing in addition to sneezing, yawning, or vocal straining. Pain is felt in the submandibular area and may radiate to the ear, eye, or shoulder.
Occipital neuralgia is not a true cranial neuralgia because it involves the greater and lesser occipital nerves that are branches of cervical spinal nerves C2 and C3. The attacks of pain are triggered from the back of the head and radiate upward over the top of the skull.
Neuropathic pain can range in intensity and intrusiveness but the symptoms of neuralgia are severe enough to require treatment. As an Orofacial Pain Specialist, Dr. Cebula has extensive training and experience in the assessment, diagnosis and treatment of all types of neuropathic pain involving the head and neck region including neuralgia.