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Neuralgia (intercostal, occipital, facial, glossopharyngeal, trigeminal, metatarsal)

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Neuralgia

Neuralgia is a painful sensation along the nerve or in the area of its representation on the body. With neuralgia, mainly sensitive parts of nerves mixed in function or sympathetic parts of the autonomic nervous system are affected.

Neuralgia by its origin can be psychogenic, occupational, infectious, traumatic, metabolic, nocturnal.

By localization, neuralgia is distinguished: occipital, facial, glossopharyngeal, trigeminal, tympanic plexus, intercostal, metatarsal, calcaneal (thalalgia), causalgia, repercussion (with ganglionitis), etc. The most common in clinical practice are pains with trigeminal neuralgia or neuralgia. Neuralgia of other localizations is much less common in patients.

Diagram of segmental innervation on the surface of the human body.

Sciatic nerve neuralgia - may be the result of post-injection neuritis (a type of traumatic neuritis). In this case, the needle and the injected drug (if it is incorrectly injected intramuscularly into the gluteus muscle) enter the thickness of the sciatic nerve, which leads to injury to its myelin sheaths and the conductive fibers themselves - axons (post-injection sciatic nerve neuritis).

With neuralgia of the sciatic nerve, a scar and adhesions form in the sheaths of the nerve, which causes compression and irritation of the nerve with the onset of pain along with its innervation (the back of the leg with a possible transition to the foot).

Intercostal neuralgia

Intercostal neuralgia - intercostal pain when the nerve sheath is damaged by the herpes virus or herpes zoster (herpetic neuritis).

With intercostal neuralgia, as a result of herpes zoster, painful vesicles appear on the skin over the projection of the intercostal nerves.

Pain along the intercostal nerve (Intercostal neuralgia) with herpes zoster has characteristic shingles and burning character, directed along with the intercostal space. It is caused by damage to the myelin sheath of the intercostal nerve itself. the herpes virus nests in it.

 

Trigeminal neuralgia

Trigeminal neuralgia - severe pain in the area of innervation by the branches of the trigeminal nerve on the face, the cornea of the eyeball, and in the mouth.

Places of pain in trigeminal neuralgia on the face.

 

Diagnosis of neuralgia

Diagnosis of neuralgia does not cause difficulties for specialists. Diagnosis of neuralgia begins with a neurological examination of a patient with typical complaints about this disease. In some cases, additional instrumental examination (electroneurography) may be required if the cause of neuralgia was trauma in the projection of the nerve.

Evaluation of the nerve in the diagnosis of neuralgia on electroneurography (ENG).

It may be necessary to conduct an MRI of the spine or any of the nerve plexuses in case of any volumetric effect on the nerve structures, as is the case with a hernia or protrusion of the intervertebral disc or soft tissue tumors, etc.

MRI examination of the lumbosacral spine in sciatic nerve neuralgia.

 

Neuralgia treatment

Neuralgia treatment is selected individually in each case. It includes a set of conservative procedures:

  • acupuncture
  • nerve and muscle stimulation
  • vitamins ("B", "C" and "E")
  • antiviral drugs
  • homeopathic remedies

In case of ineffectiveness of the conducted conservative therapy, the patient may require surgical treatment (neurolysis of the nerve trunk, etc.).

Elimination of pain and restoration of sensitivity in intercostal neuralgia is accelerated with the use of physiotherapy.

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