pain in a nerve or along the course of one or more nerves, usually consisting of a sharp, spasmlike pain that may recur at intervals. It is caused by inflammation of or injury to a nerve or group of nerves. Inflammation of a nerve, or neuritis
, may affect different parts of the body, depending upon the location of the nerve. Two common types of neuralgia are that of the trigeminal nerve (see tic douloureux
) and that of the sciatic nerve (see sciatica
). adj., adj
Fothergill's neuralgia tic douloureux (trigeminal neuralgia).
glossopharyngeal neuralgia that affecting the petrosal and jugular ganglion of the glossopharyngeal nerve, marked by severe paroxysmal pain originating on the side of the throat and extending to the ear.
idiopathic neuralgia neuralgia of unknown etiology, not accompanied by any structural change.
intercostal neuralgia neuralgia of the intercostal nerves, causing pain in the side.
mammary neuralgia neuralgic pain in the breast.
tenderness or pain in the metatarsal area of the foot and in the third and fourth toes caused by pressure on a neuroma of the branch of the medial plantar nerve supplying these toes. The neuroma is produced by chronic compression of the nerve between the metatarsal heads. Called also Morton's foot or toe.
The pain of Morton's neuralgia is frequently made worse with prolonged standing or walking. From Waldman, 2002.
nasociliary neuralgia pain in the eyes, brow, and root of the nose.
persistent burning pain and tingling along the distribution of a cutaneous nerve following an attack of herpes zoster
neuralgia (noo-ral'ja, nu- ) [ neuro- + -algia]
Pain occurring along the course of a nerve. It may be caused by pressure on nerve trunks, nutritional deficiencies, toxins, or inflammation. Synonym: neurodynia
(-ral'jik ), adjective
cardiac neuralgiaAngina pectoris.
facial neuralgiaTrigeminal neuralgia.
geniculate neuralgiaRamsay hunt syndrome.
Neuralgia along the course of the glossopharyngeal nerve, characterized by severe pain in back of the throat, tonsils, and middle ear.
An impression of local pain without an actual stimulus to cause the pain.
Hunt neuralgiaRamsay Hunt syndrome.
Neuralgia without structural lesion or pressure from a lesion.
Pain between the ribs. It is frequently associated with eruption of herpes zoster on the chest, and with costochondritis, an inflammatory condition of the ribs and their cartilage. Synonym: pleuralgia
Morton neuralgia See: Morton neuralgia
Neuralgia of the eyes, brows, and root of the nose.
Neuralgia involving the upper cervical nerves, usually caused by nerve entrapment.
otic neuralgiaGeniculate neuralgia.
Nerve pain that persists for more than three months after the rash of herpes zoster (shingles) resolves.
Continued mental perception of pain after neuralgia has ceased.
Neuralgia of the sphenopalatine ganglion, causing pain in the area of the upper jawbone and radiating into the neck and shoulders. There is pain on one side of the face radiating to the eyeball, ear, and occipital and mastoid areas of the skull, and sometimes to the nose, upper teeth, and shoulder on the same side.
Neuralgia due to irritation of nerves at the site of an amputation.
Neuralgia not primarily involving the nerve structure but occurring as a symptom of local or systemic disease.
Former term for trigeminal neuralgia.
A painful disease of the trigeminal (fifth cranial) nerve marked by brief attacks of lightning-like stabs along the distribution of one or more of its branches, but usually along the maxillary nerve. The attacks typically last from a few seconds to 2 min and may be triggered by light touch to a hypersensitive area, drinking hot or cold beverages, chewing, brushing teeth, smiling, or talking. It occurs most frequently in people over 40 and in women more often than men and on the right side of the face more often than the left. Synonym: facial neuralgia
; tic douloureux
Symptoms include episodes of facial pain, often accompanied by painful spasms of facial muscles. Between attacks the patient may be pain-free. When observed during an attack, the patient will often try to splint or in other ways protect the affected area. In long-standing cases, the hair on the affected side sometimes becomes coarse and bleached. Physical examination shows no motor or sensory function impairment.
The cause is thought to be the pressure of blood vessels on the trigeminal nerve root at its point of entrance into the brainstem. Magnetic resonance imaging is used to identify other potentially hazardous causes of facial pain.
Carbamazepine, phenytoin, or other anticonvulsant drugs in gradually increasing doses are often effective. Other therapeutic options include narcotic analgesics or muscle relaxers such as lioresal. Nerve block provides temporary relief. Surgical therapies are various and may include rhizotomy, microsurgical nerve root decompression, or nerve root injections. Radiation therapy is sometimes employed.
The characteristics of each attack are observed and recorded. Analgesic drugs are administered as prescribed and observed for desired and adverse effects. Before surgery is contemplated, an effort should be made to reduce factors that make symptoms worse, e.g., by having the patient use a cotton pad to cleanse the face and a blunt-toothed comb to comb the hair.
After surgery, sensory deficits are assessed to prevent trauma to the face and affected areas. The patient who has had an ophthalmic branch resection should avoid rubbing his or her the eye, avoid using aerosol sprays, wear glasses or goggles outdoors, blink often, and examine the eye for foreign substances with a hand mirror frequently. The patient who has had a mandibular or maxillary branch resection should eat carefully to avoid oral injuries from hot food or drinks or chewing, e.g., by eating food on the unaffected side to prevent inner cheek injury. Frequent dental examinations detect abnormalities that the patient cannot feel. The patient and significant others require emotional support throughout treatment. Expression of feelings should be encouraged, and independence promoted, helping the patient to avoid trigger stimulation while carrying out self-care and physical activities.