neuralgic

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neu·ral·gic

(nū-ral'jik),
Relating to, resembling, or of the character of, neuralgia.

neu·ral·gic

(nūr-al'jik)
Relating to, resembling, or of the character of, neuralgia.

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 See: sciaticaneuralgic (-ral'jik ), adjective

cardiac neuralgia

Angina pectoris.

facial neuralgia

Trigeminal neuralgia.

geniculate neuralgia

Ramsay hunt syndrome.

glossopharyngeal neuralgia

Neuralgia along the course of the glossopharyngeal nerve, characterized by severe pain in back of the throat, tonsils, and middle ear.

hallucinatory neuralgia

An impression of local pain without an actual stimulus to cause the pain.

Hunt neuralgia

Ramsay Hunt syndrome.

idiopathic neuralgia

Neuralgia without structural lesion or pressure from a lesion.

intercostal neuralgia

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

mammary neuralgia

Neuralgia of the breast. Synonym: mastodynia

Morton neuralgia

See: Morton neuralgia

nasociliary neuralgia

Neuralgia of the eyes, brows, and root of the nose.

occipital neuralgia

Neuralgia involving the upper cervical nerves, usually caused by nerve entrapment.

otic neuralgia

Geniculate neuralgia.

postherpetic neuralgia

Nerve pain that persists for more than three months after the rash of herpes zoster (shingles) resolves.

reminiscent neuralgia

Continued mental perception of pain after neuralgia has ceased.

sphenopalatine neuralgia

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.

stump neuralgia

Neuralgia due to irritation of nerves at the site of an amputation.

symptomatic neuralgia

Neuralgia not primarily involving the nerve structure but occurring as a symptom of local or systemic disease.

trifacial neuralgia

Former term for trigeminal neuralgia.

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

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.

Etiology

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.

Treatment

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.

Patient care

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.