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Paroxysmal neuralgias are characterized by paroxismal,
stinging pains, of extreme violence but of very short duration,
localized within the area of distribution of the affected nerve, and
triggered by slight (painless) stimulation of a small skin or mucous
area right on the region of the same nerve (trigger points). There
is also a sensory deficit. This group of neuralgias has been, in
turn, divided into subgroups:
1) major neuralgias that
include trigeminal and glossopharingeal neuralgias
2) minor
neuralgias of the intermediate, vagus and greater occipital nerves,
more rare and less defined (biblio 24, 1,
2)
Trigeminal neuralgia (branches I – II –
III)
Essential trigeminal
neuralgia
Features:
- unilateral
- one or more branches
of the trigeminal nerve involved
- stabbing, electric shock like
pain
localized
sudden, sharp,
stabbing
severe intensity
triggered
by certain stimuli to trigger ponts (chewing, hairdrying, washing
the face, brushing the teeth can be triggers)
- absence of
neurologic disorders
- individual attacks are identical
-
structural lesion excluded on the basis of anamnesis (patient’s
history)
Onset of symptoms occurs most often after age
55 |
Other cranial
neuralgias
- glossopharyngeal n.pain
location: ear, base
of the tongue, tonsillar fossa, retromandibular
triggered by
coughing, hairdrying, swallowing
- intermediate
n.pain
location: ear canal
- superior laryngeal
n.pain
location: side of the throat, angle of the jaw under the
ear
triggered by swallowing, shouting, head rotation
-
occipital nervepain
location: points of emergence of the greater
and lesser occipital nerves (lateral cervical).
The diagnosis is
difficult when cervical pains co-exist.
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