Neuralgia: Difference between revisions

{{shortShort description|Pain disorder characterizecharacterized by pain in the distribution of a nerve or nerves}}

{{aboutAbout|pain in the areadistribution supplied byof a particular nerve or nerves|pain more generally caused by damagea tolesion or disease of the somatosensory nervous system|Neuropathic pain}}

'''Neuralgia''' (Greek ''neuron'', "nerve" + ''algos'', "pain")<!--from ''Dorlands Illustrated Medical Dictionary'' ISBN 9781416062578 Elsevier Health Sciences 2011--> is pain in the distribution of a nerve or nerves, as in [[intercostal nerve|intercostal]] neuralgia, [[trigeminal neuralgia]], and [[glossopharyngeal nerve|glossopharyngeal]] neuralgia.<ref>{{cite web |url=https://www.iasp-pain.org/Educationresources/terminology/Content.aspx?ItemNumber=1698#Neuralgia |work=[[International Association for the Study of Pain]] |title=IASP Terminology: neuralgia |access-date=1615 AprilNov 20202023}}</ref> as in [[intercostal nerve|intercostal]] neuralgia, [[trigeminal neuralgia]], and [[glossopharyngeal nerve|glossopharyngeal]] neuralgia.

A neuron's response to trauma can often be determined by the severity of the injury, classified by [[Seddon's classification]]. In Seddon's Classification, nerve injury is described as either [[neurapraxia]], [[axonotmesis]], or [[neurotmesis]]. Following trauma to the nerve, a short onset of afferent impulses, termed "injury discharge", occurs. WhileThis lastingoccurrence lasts only minutes, this occurrencebut has been linked to the onset of neuropathic pain.<ref name="LA">{{cite book|author=P. Prithvi Raj|title=Practical Management of Pain|date=14 June 2000|publisher=Mosby|isbn=978-0-8151-2569-3|url-access=registration|url=https://archive.org/details/practicalmanagem0003unse}}</ref>

Neuralgia is more difficult to treat than other types of pain because it does not respond well to normal pain medications. Special medications have become more specific to neuralgia and typically fall under the category of membrane stabilizing drugs or [[antidepressants]] such as [[Cymbaltaduloxetine]] (Cymbalta). The antiepileptic medication(AED) [[Lyricapregabalin]] (pregabalinLyrica) was developed specifically for neuralgia and other neuropathic pain as a successor to [[Neurontingabapentin]] (gabapentinNeurontin).{{citation needed|date=August 2021}}

High doses of anticonvulsant medicines—used to block nerve firing— and tricyclic antidepressants are generally effective in treating neuralgia. If medication fails to relieve pain or produces intolerable side effects, surgical treatment may be recommended.<ref name="ste">Stechison, Michael. Personal INTERVIEW. 18 November 2008.</ref>{{Primary source inline|date=July 2010}}<ref>{{Cite journal |last=Galer |first=B. S. |year=1995 |title=Neuropathic pain of peripheral origin: Advances in pharmacologic treatment |journal=Neurology |volume=45 |issue=129 |pages=S17–S25 |doi= 10.1212/WNL.45.12_Suppl_9.S17|url=http://www.neurology.org/cgi/content/abstract/45/12_Suppl_9/S17 |pmid=8538882 |s2cid=38518116 }}</ref>

Some degree of facial numbness is expected after most of these surgical procedures, and neuralgia might return despite the procedure's initial success. Depending on the procedure, other surgical risks include hearing loss, balance problems, infection, and stroke. These surgeries include [[rhizotomy]] (where select nerve fibers are destroyed to block pain) and [[Microvascularmicrovascular decompression]] (where the surgeon moves the vessels that are compressing the nerve away from it and places a soft cushion between the nerve and the vessels).<ref name="dwo">{{Cite journal|last1=Dworkin|first1=R. H.|last2=Backonja|first2=M.|last3=Rowbotham|first3=M. C.|last4=Allen|first4=R. R.|last5=Argoff|first5=C. R.|last6=Bennett|first6=GJ|last7=Bushnell|first7=MC|last8=Farrar|first8=JT|last9=Galer|first9=BS|last10=Haythornthwaite|first10=Jennifer A.|last11=Hewitt|first11=David J.|display-authors=8|year=2003|title=Advances in neuropathic pain - Diagnosis, mechanisms, and treatment recommendations|journal=Archives of Neurology|volume=60|issue=11|pages=1524–1534|doi=10.1001/archneur.60.11.1524|pmid=14623723|doi-access=free|first16=Christoph|last16=Stein|last12=Loeser|first12=John D.|last13=Max|last14=Saltarelli|first14=Mario|last15=Schmader|first15=Kenneth E.|first21=Sharon M.|last17=Thompson|last21=Weinstein|first20=Linda R.|last20=Watkins|first19=Mark S.|last19=Wallace|first18=Dennis C.|last18=Turk|first17=David|first13=Mitchell B.}}</ref>

* Shankland, Dr. Wesley E. ''Face the Pain -: The Challenge of Facial Pain'', (Omega Publishing, 2001). Dr. Shankland is a former associate editor of ''The Journal of Craniomandibular Practice''.