Neuralgia of the trigeminal nerve – treatment, causes,symptoms, first signs

Neuralgia of the trigeminal nerve is quite common.
disease of the peripheral nervous system, the main feature
which is paroxysmal, very intense pain in the area
innervation (connection with the central nervous system) of one of
branches of the trigeminal nerve.

Neuralgia of the trigeminal nerve is not painless, it is
pretty serious affliction. This disease most often affects women.
at the age of 50-70 years. AT некоторых случаях требуется даже
surgical intervention.

What is neuralgia, types of disease

Невралгия тройничного нерва

The trigeminal nerve originates from the anterior stem of the pons
the bridge, located next to the middle legs of the cerebellum. is he
formed from two roots – large sensing and small
motor. Both roots from the base point are directed to the top.
temporal bone.

Motor spine along with the third sensory branch goes
through the oval hole and further connects with it. ATо впадине на
level of the upper part of the pyramid bone is the lunate site. Of
there are three main sensory branches of the trigeminal nerve (see
a photo).

тройничный нерв

Neuralgia in translation means pain along the nerve. Having in
structure 3 branches, the trigeminal nerve is responsible for sensitivity
one side of the face and innervates strictly defined zones:

  • 1 branch – orbital region;
  • 2 branch – cheek, nostril, upper lip and gum;
  • 3 branch – the lower jaw, lip and gum.

ATсе они на своем пути следования к иннервируемым структурам
pass through certain holes and channels in the bones of the skull, where
may be subject to pressure or irritation.  Neuralgia 1
branches of the trigeminal nerve is extremely rare, most often
2 and / or 3 branch is affected.

If one of the branches of the trigeminal nerve is struck, then
manifest a variety of violations. For example, the area of ​​innervation
may become insensitive. Sometimes, on the contrary, it becomes
too sensitive, almost to a painful condition. Often
part of the face sags, or becomes less mobile.

Conventionally, all types of trigeminal neuralgia can be divided into
primary (true) and secondary neuralgia.

  1. Primary (true) neuralgia is considered a separate pathology,
    caused by compression of the nerve or circulatory disorders
    in this region.
  2. ATторичная невралгия – результат других патологий. To them
    include tumor processes, severe infectious


The exact cause of the development of trigeminal neuralgia is not clear,
as mentioned above, refers to idiopathic diseases.
But there are factors that most often lead to the development
данного diseases.

Withчины развития тригеминальной невралгии самые различные:

  • compression of the nerve in the area of ​​its exit from the cranial cavity through
    bone canal with abnormal position of the head vessels
  • vessel aneurysm in the cranial cavity;
  • metabolic disorders: gout, diabetes, diseases
    щитовидной железы и другие эндокринные патологии;
  • hypothermia face;
  • chronic infectious diseases in the facial area
    (chronic sinusitis, dental caries);
  • metabolic disorders (diabetes, gout);
  • chronic infectious diseases (tuberculosis, brucellosis,
    syphilis, herpes);
  • mental disorders;
  • suppuration of the bones of the skull, especially the jaws (osteomyelitis);
  • severe allergic diseases;
  • helminthiasis (worms);
  • multiple sclerosis;
  • brain tumors.

Symptoms of trigeminal neuralgia

Симптомы при невралгии тройничного нерва

The disease is more common in middle-aged people, more often
diagnosed in 40-50 years. Female sex suffers more often than male.
More often there is a lesion of the right trigeminal nerve (70% of all
cases of disease). Very rarely, trigeminal neuralgia may
be two-way. The disease is cyclical, that is,
periods of exacerbation are replaced by periods of remission. Aggravations over
characteristic of the autumn-spring period.

So, the typical signs of pain in neuralgia
trigeminal nerve:

  • the nature of the pain in the face – shooting, extremely hard;
    patients often compare it with electric discharge
  • duration of neuralgia attack – 10-15 seconds (not more than two
  • the presence of a refractory period (the interval between
  • localization of pain – does not change over several
    years old
  • pain of a certain direction (from one part of the face passes
    to another)
  • the presence of trigger zones (areas of the face or mouth,
    irritation which causes a typical paroxysm)
  • the presence of trigger factors (actions or conditions under which
    there is a painful attack; for example, chewing, washing,
  • characteristic behavior of the patient during the attack – no
    crying, screaming and a minimum of movement.
  • twitching chewing or facial muscles at the peak of pain
    an attack.

Of вторичных симптомов невралгии тройничного нерва следует
highlight phobic syndrome. is he формируется на фоне «охранительного
behavior “when a person avoids certain movements and postures,
чтобы не спровоцировать обострение diseases.

  1. Chewing food by the side which is the opposite of pain
  2. Neuropathic complications of neuralgia lead to secondary
    pain in the head;
  3. Concomitant irritation of the auditory and facial nerves.

Symptoms difficult to interpret correctly if pain syndrome
expressed in the patient slightly.

Due to the fact that all patients with trigeminal neuralgia
nerve, use only the healthy half of the mouth for chewing,
the opposite side is formed muscle seals. With
prolonged course of the disease may develop dystrophic
changes in masticatory muscles, and a decrease in sensitivity to
affected side of face.

Localization of pain

Pain attacks may not be single, but with a small
interval follow each other. Pathogenesis of neuralgia
the trigeminal nerve is very diverse:

  1. Usually discomfort in any part of the face
    in the form of an attack.
  2. Pain binds a person for a couple of minutes and temporarily retreats.
    Then comes again. Between painful attacks passes from 5 minutes to
  3. Defeat is like a stun shock. Discomfort usually
    localized in one part of the face, but often the patient feels pain
    immediately in several places.
  4. It seems to a person that pain covers the whole head, the eye area,
    ears, nose. Speaking during an attack is very difficult.
  5. From the pain, reducing the oral cavity, to pronounce the words
    extremely difficult. With этом могут сильно дергаться мышцы.

Others are similar in symptoms of trigeminal neuralgia.
diseases. These include temporal tendinitis, Ernest syndrome and
neuralgia of the occipital nerve. With височном тендините боль
captures the cheek and teeth, there is a headache and pain in the area

With невралгии затылочного нерва боль, обычно, располагается
front and back of the head and can sometimes spread to the area

What most often causes pain in trigeminal neuralgia
a nerve?

In the event that the patient has neuralgia, then each
an attack occurs due to irritation of the trigeminal nerve,
due to the existence of trigger, or “trigger” zones. They
localized on the face: in the corners of the nose, eyes, nasolabial folds. With
irritated, sometimes extremely weak, they can begin
�”Generate” a steady, long painful impulse.

Factors of pain can be:

  1. shaving procedure for men. Therefore, the appearance of the patient with
    a shaggy beard can bring an experienced doctor to “neuralgia with
    experience “;
  2. просто легкое поглаживание faces. Such patients protect the face
    very carefully, do not use a handkerchief, napkin.
  3. the process of eating, the procedure for brushing your teeth. Oral muscle movements
    cavities, buccal muscles and pharyngeal constrictors cause pain,
    as the skin of the face begins to shift;
  4. fluid intake process. One of the painful states, because
    the quenching of thirst is punished with extreme pain;
  5. ordinary smile, as well as crying and laughing, talking;
  6. applying makeup on the face;
  7. the feeling of sharp odors, which are called “trigeminal” –
    acetone, ammonia.

Последствия невралгии для человека

Neuralgia of the trigeminal nerve in neglected state leads to
certain consequences:

  • paresis of the muscles of the face;
  • hearing impairment;
  • facial paralysis;
  • development of asymmetry of the face;
  • prolonged pain;
  • damage to the nervous system.

The risk group consists of people of the older age category (more often
women), people suffering from cardiovascular diseases or with
impaired metabolism.



Neurologist needs to differentiate frontal glaucoma,
dental disease, otitis media, mumps, ethmoiditis or sinusitis. For this
prescribe a comprehensive survey.

Usually the diagnosis of trigeminal neuralgia is made on the basis of
complaints of the patient and his inspection. In the diagnosis of the cause of neuralgia has
the value of magnetic resonance imaging. It allows you to identify
swelling or signs of multiple sclerosis.

Basic diagnostic methods:

  1. Consultation of a neurologist. Primary Physician
    inspection determines further types of examination.
  2. Dental examination. Neuralgia often occurs on
    background dental diseases, low-quality prostheses.
  3. Panoramic x-ray of the skull and teeth. Helps
    see formations that could pinch a nerve.
  4. MRI The study helps to see the structure of the nerves, the presence and
    localization of vascular pathologies, various types of tumors.
  5. Electromyography – designed to study the features
    the passage of impulses along the nerve.
  6. Blood test – eliminates viral origin
    pathological changes in the trigeminal nerve.

If you are diagnosed with neuralgia, then do not be scared,
overall, the prognosis is favorable, but it plays a big role
timely treatment.

Treatment of trigeminal neuralgia

To cure this disease is extremely difficult and not always even radical
treatment methods are positive. But the right therapy
allows you to remove pain and greatly alleviate suffering

To the main methods of treatment for trigeminal neuralgia

  • medication;
  • physiotherapy;
  • surgical treatment.


AT different groups are used in drug treatment
medicines, including such as:

  • Anticonvulsant drugs
  • Antispasmodics and muscle relaxants.

Before using any drug, consultation is necessary.

Finlepsin for trigeminal neuralgia is one of
most common anticonvulsants. Active ingredient
This drug is carbamazepine. This tool plays a role
analgesic for idiopathic neuralgia or a disease that
arose against multiple sclerosis.

In patients with trigeminal neuralgia, Finlepsin suppresses
the onset of attacks of pain. The effect is noticeable after 8 – 72 hours after
taking the drug. The dosage is selected only by a doctor.
individually for each patient.

The dose of Finlepsin (carbamazepine), when taken by patients
can safely talk and chew, should remain
unchanged during the month, after which it is necessary to gradually
to reduce. Therapy with this drug can last as long as
the patient does not notice the absence of seizures for half a year.

Other drugs for trigeminal neuralgia:

  • Gabapentin;
  • Baclofen;
  • ATальпроевая кислота;
  • Lamotrigine;
  • Pregabalin.

Each of these medicines has indications for
application in trigeminal neuralgia. Sometimes data
препараты не помогают, поэтому назначается фенитоин в дозе 250
mg. The tool has a cardiodepressive effect, therefore it should
be introduced slowly.


Physiotherapy включают парафиновые аппликации,
the use of different types of currents, acupuncture. To
get rid of the strongest pains, doctors make the patient
alcohol-novocaine blockade. This is enough for a while, but
blockades are less effective each time.

  • Withменяются следующие методы:
  • Acupuncture;
  • Magnetic therapy;
  • Ultrasound;
  • Laser therapy;
  • Electrophoresis with drugs.

Surgical treatment of trigeminal neuralgia

With хирургическом лечении врач пытается устранить сдавливание
blood vessel of the nerve trunk. AT других случаях проводится
destruction of the trigeminal nerve itself or its node with the purpose
relief of pain.

Surgical treatment of trigeminal neuralgia
often minimally invasive. In addition to surgical
the method applies and so-called. radiosurgery – bloodless intervention,
requiring no cuts or seams.

There are the following types of operations:

  1. Percutaneous surgery. Withменяют на ранних стадиях diseases. Under
    local anesthesia trigeminal nerve is destroyed by acting on it
    chemicals or radio waves.
  2. Nerve decompression. Such an operation is aimed at correcting
    locations of arteries that compress the trigeminal nerve.
  3. Radiofrequency destruction of the nerve root. With этой операции
    destroy only a certain part of the nerve.

ATид операции назначается в зависимости от индивидуальных
features of the patient’s disease.

A characteristic feature of all surgical methods is
more pronounced effect in their early conduct.  Those. than
The earlier an operation is performed, the higher the probability

Folk remedies for use at home

How to treat neuralgia folk remedies? With использовании
folk remedies it is important to remember that in this way only
symptomatology. Of course, first of all, you should use
folk recipes that can effectively help combat
inflammatory process.

ATажно помнить, что применение того или иного метода лечения
must be negotiated with a doctor. Pay attention to the consequences
which can bring drug treatment.

Folk remedies for the treatment of neuralgia at home:

  1. Birch juice. Withнимая его внутрь или смазывая им пораженную
    neuralgia side of face can reduce symptoms
    diseases. Drink this juice should be 4-5 glasses a day.
  2. Beets rubbed on a coarse grater. Make a small bandage
    envelope (bandage rolled up in several layers), in which
    put in grated beets. Such convolutions are introduced into the auditory
    passage from the side where there was inflammation.
  3. Black radish juice will also help. It can be mixed with lavender
    tincture or essential oil of lavender and rub into a sore spot.
    Потом следует обернуться шарфом и полежать полhours Valid at
    attack do fumigate the room in which the patient is.
    For this нужна полынная сигара. It is twisted from dry leaves.
    wormwood and set on fire. Fumigation should last no more than 7-10 minutes.
    It is necessary to make such manipulations within a week.
  4. In a frying pan, heat a glass of buckwheat, pour the cereal into
    cotton bag and apply to the affected area. Pouch
    clean when it is completely cold. This procedure is carried out
    twice a day.
  5. We treat trigeminal neuralgia with chemist’s chamomile – beautiful
    sedative at NTN. You can make morning tea from it.
    Some warm drink should be taken by mouth, but not
    swallow, and keep it as long as possible.
  6. Horseradish root grate, wrap received
    gruel in a napkin and apply in the form of lotions to the affected
  7. To relieve tension in the body and relieve neuralgic
    pains are recommended hot tubs with the addition of a decoction of young bark
    aspen trees.


Of course, affect all likely causes
disease is not possible (for example, congenital
channel narrowness cannot be changed). However can prevent
Many factors for the development of this disease:

  • avoid hypothermia face;
  • timely treat diseases that may cause
    trigeminal neuralgia (diabetes mellitus, atherosclerosis, caries,
    sinusitis, frontalitis, herpes infection, tuberculosis, etc.);
  • prevention of head injuries.

It should also be borne in mind that the methods of secondary prevention
(i.e., when once the disease has already manifested itself)
high-quality, complete and timely treatment.

So, getting rid of ternary neuralgia is possible.
You only need time to seek help from specialists and
get tested. Neurologist will immediately appoint the necessary
drugs to combat the disease. If such funds do not help in
fight against trigeminal neuralgia, resort to the help of a neurosurgeon,
which solves the problem promptly.

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