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Inflammation of the trigeminal nerve or trigeminal neuralgia

Such an interesting disease as trigeminal neuralgia (trigeminal neuralgia or popularly called “trigeminal nerve inflammation”) has been known since ancient times, due to its vivid clinical picture.

From the middle of the 18th century began to appear the scientific work of European doctors, mainly belonging to British military doctors. The fact is that the damp and cold climate of “foggy Albion” contributed to the development of this disease.

They were treating bouts of facial pain at the time with opium tincture, and not without success, but the patients got out of the fire and into the fire, becoming addicted to drugs.

Even now, in cases of severe and treatment-resistant cases, the use of narcotic analgesics has been shown (for example, in the form of an application of the Durogesic patch containing fentanyl).

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Trigeminal neuralgia - what is it?

inflammation of the trigeminal nerve

Symptoms of inflammation of the trigeminal nerve, photo 1

It should be said immediately that neuralgia is a functional state in which, for not quite understandable reasons, the nerves themselves, which normally only obediently transmit information from the peripheral receptors to the center without distortion, suddenly begin to distort it by adding "their own signal."

Radio technicians would call these signals "interference in the wires", "short circuit". And the nerves give rise to an extremely powerful pain impulse, in the form of a series of discharges.

It happens suddenly, and against the background of complete health. Therefore, such a phrase as "inflammation of the trigeminal nerve on the face" is meaningless, and twice. By the way, the word “on the face” cannot be added at all, since the trigeminal nerve is not found anywhere else on the body.

Triple neuralgia is an attack of sharp and sudden pain, usually in one (left or right half of the face). These pains have a sudden start and the same ending.

About trigeminal, facial nerve and neuritis

The location of the trigeminal nerve on the face, photo 2

The location of the trigeminal nerve on the face, photo 2

It should be said about extremely low medical literacy of the population, and about not knowing the device of their own organism. So, on the Internet you can even read such a popular query: "inflammation of the trigeminal facial nerve." To avoid confusion let us clarify.

Firstly, each person has two trigeminal nerves (right and left), which are sensitive, collecting sensations from the oral cavity, nasal cavity, face skin, eye conjunctiva. This is V pair of cranial nerves.

In addition, the trigeminal nerve carries motor fibers (thanks to this part, we can chew), and secretory, vegetative branches. It is on them that tearing depends, the discharge of water from the nose when smoke enters it, and so on.

Also, a person has two facial nerves (right and left) or a VII pair, which “direct” the movement of facial muscles.

Nerve inflammation is optic neuritis. Neuritis and neuralgia are different conditions. A sore nerve can ache if it contains sensitive fibers, since pain is a sensation.

And if the nerve is purely motorized, then its functions are disturbed during inflammation (neuritis) - painless paralysis of the muscles that stop moving occurs.

This is what happens in neuritis of the facial nerve, or "Bell's palsy." In order not to be distracted from the topic, everyone can google it and see everything that happens during paralysis or paresis of the facial nerve.

Causes of trigeminal neuralgia

Causes of trigeminal neuralgia

photo 3

As mentioned above, the trigeminal neuralgia is an outbreak of pain that is born “inside” the nerve, and resembles a convulsive discharge of neurons in the cerebral cortex, only it has not a motor, but a sensitive character.

What reasons can lead to this unpleasant situation? - Compression of the trigeminal nerve and its structures, or squeezing it from the outside.

Here it must be said that the trigeminal nerve, entering the cranial cavity, forms a powerful node, which is called the trigeminal ganglion, or Gasser's node, by the name of the scientist who described it.

It is the gassere ganglion (in the photo) that is the place where all three branches of the trigeminal nerve enter into it - the mandibular, maxillary and orbital nerves on each side. Naturally, for each person in the depth of the skull, two such nodes lie on the main bone - for the right and left trigeminal nerves.

Which object squeezes the trigeminal ganglion? This may be a vessel (artery), which “bent” over time, and with its “knee” it injures and irritates the ganglion. Most often it is the superior cerebellar artery. Sometimes this vessel "swells up", forming a protrusion, or aneurysm. That she could be to blame for the attacks of persistent pain.

Sometimes a simple increase in pressure causes this symptom, it happens in pregnant women, because blood pressure must be higher in order to supply the baby with blood. Therefore, seizures of the trigeminal neuralgia in pregnant women are functional, and disappear after birth.

Defects in the nerve sheath. The process is called “demyelination”, as the nerve trunks are “wrapped” in the myelin for reliable impulse conduction. This is reminiscent of the condition in which the wire’s insulation is broken. He will "spark."

This happens, for example, in multiple sclerosis or OREM (acute disseminated encephalomyelitis). In this case, trigeminal neuralgia is considered symptomatic because it is a manifestation of another disease.

Tumor growth. Most commonly, nerve compression can occur with a neuroma, which comes from the nerve itself. Sometimes the cause is nodules with neurofibromatosis. In more rare cases, these symptoms may indicate a malignant neoplasm.

Consequences of injury or post-traumatic trigeminal neuralgia. By “injury” is meant a severe injury in which a person was unconscious, maybe even in the intensive care unit.

Post-traumatic cysts appear in the brain, which also “squeeze” the trigeminal ganglion.

Herpes - perhaps the only inflammatory condition leading to neuralgia. Sometimes it “pours out” on the face with stripes along the branches of the trigeminal nerve. This is an unfavorable sign, indicating a significant decrease in immunity.

An antiviral treatment is urgently needed, otherwise persistent, exceptionally violent and persistent facial pains with a burning tinge are possible. They last months, and even years after the rash. This condition is called postherpetic neuralgia.

What is the "trigger zones"?

This term refers to special areas of skin and mucous membranes on the face, the touch or slightest irritation of which triggers an attack of pain, just as the slightest movement of a finger pulls the cocked trigger and a shot occurs. The second name is “trigger zones”.

These points cause the nerve to radiate pain under the influence of muscle spasm, hypothermia, movement, chewing, the breath of the breeze, cold air.

Sometimes it is impossible to shave, as touching causes severe pain. These points are usually located in the corners of the nose, mouth, above the eyes - at the junction of the innervation of the trigeminal nerve branches.

Eating hot foods, brushing your teeth, applying blush and shadows on your face, just stroking, laughing or crying can all cause severe pain.

The bad property of this pain is its closed circulation in the cells of a gasserov node, in which it is very difficult to interrupt this excited state of neurons, due to self-induction. Therefore, some patients reach exhaustion because of the fear of extreme pain while eating.

In addition, sharp odors (acetone, ammonia, smoke, chlorine), which irritate the end of the trigeminal nerve, can cause seizures. Even simple perfumes can be the cause of painful and long suffering.

Symptoms of trigeminal inflammation - neuralgia

Symptoms of trigeminal inflammation

Neuralgia manifestation, photo 4

How do these “symptoms of inflammation of the trigeminal facial nerve,” as they say on the Internet?

Neuralgia is characterized by:

  1. Lightning pain, like an electric shock to the face, is very strong.
  2. The pain is localized in one half of the face: nose, lips, cheeks, gums. The frontal areas are less frequently affected, since innervation is better in the nasolabial area.
  3. The pain does not give anywhere, neither in the neck, nor in the ear, nor in the arm, but is limited to its zone of excitation of the nerve - also almost always is one-sided.
  4. Attacks last from a few seconds to a minute, then a sharp ending and a “light gap” that can last from several days to weeks. In severe cases, symptomatic neuralgia, for example, with the growth of the tumor - they become shorter and seizures occur at smaller and shorter intervals.
  5. The pain in the "inflammation of the trigeminal nerve" is sometimes accompanied by vegetative symptoms: redness of the skin of the face, dilated pupils, tearing on the affected side.

Diagnosis of trigeminal neuralgia

The statement of the syndrome diagnosis of neuralgia in the neurologist's office usually does not cause difficulties, due to the bright and characteristic picture of the manifestation. But it is much more important to make sure that there is no volumetric process inside the brain.

Therefore, only magnetic resonance imaging , CT - contrasting angiography allows you to "relax" and treat neuralgia. In the event that a volumetric or vascular process is found, surgical treatment is possible in neurosurgeons.

Additional conditions are a good resolution ability of a magnetic tomograph, which should be at least 1.5 Tesla in terms of the strength of a magnetic field voltage. This is equivalent to detecting foci of about 1.5 mm in diameter and less.

Treatment of inflammation of the trigeminal nerve, photo

Treatment of "inflammation" of the trigeminal nerve, the blockade of the Gasser ganglion

Methods of treatment - blockade of gasserov node, photo 5

As with many other diseases, therapeutic methods are first worked out, and only then they are referred to neurosurgeons. It should be said that surgical treatment is possible even if there is no volumetric process. It affects the nerve itself.

Drug treatment

We list the main methods of conservative treatment of trigeminal neuralgia:

  1. Anticonvulsant drugs. Suppress the occurrence of arousal. As a rule, therapy begins with the prescription of carbamazepine.
  2. Muscle relaxants central action (tolperisone, tizanidine). They help relieve chronic muscle spasm on the face, which often underlies the activation of the trigger zones.
  3. With the neuropathic, burning nature of pain, gabapentin and its analogs (Neurontin, Lyrics) are used.

Conventional painkillers are ineffective, since the mechanism of pain in neuralgia is completely different.

Surgical treatment

  1. It is possible to perform a blockade of the branches of the nerve, which brings relief in a few months.
  2. Perform blockade of Gasser's node (glycerol rhizotomy). This operation "kills" the ganglion.
  3. Radio-frequency destruction of a node.
  4. Cutting nerve root.

As can be seen, modern medicine, if powerless to cure pain, is forced to simply destroy the structures that create it. There is no other way yet.

Of course, instead of pain, there is a constant “frozen” half of the face, due to loss of sensitivity along with pain, but you have to pay for everything.

These patients need to visit the dentist more often, since teeth on one side completely stop aching, and they often bite the cheek.

The structure of the trigeminal nerve, photo

The structure of the trigeminal nerve, photo

Home treatment

The defeat of the trigeminal nerve refers to such diseases that any intervention - clay masks, heating, rubbing - can only "tease" the trigger zones. Therefore, home treatment is reduced to creating a calm, stressless atmosphere and lack of drafts.

Prevention

Important for the prevention of attacks is nutrition, without an excess of stimulating products: coffee, alcohol. Food should not be hot or cold. It is recommended to limit the salt.

It is necessary to guard against colds, improve immunity, promptly treat any manifestation of “herpes on the lips”, put teeth in order and cure chronic diseases of ENT organs.

Only in this case, we can hope for a decrease in the number of attacks, and in the case of a competent treatment - to completely get rid of this pain.

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