By the Department of Oral Pathology & Microbiology, Yenepoya Dental College
The term Neuralgia means pain along the course of the nerve.“Neura” means nerve; “Algia” means pain.
Causes: The causes of such nerve pain are many. The major reason is due to pressure on nerves by nearby bones, ligaments, blood vessels, or tumors. Other reasons are chemical irritation, diabetes, viral infections such as Herpes zoster (shingles), certain medications, and trauma (including surgery).
The major neuralgias of the orofacial area include the following:
Trigeminal neuralgia: Pain along the course of the trigeminal nerve (major nerve of the face) Symptoms: Severe, Sharp, pricking pain like an electric shock, last for few seconds to minutes and appears and disappears suddenly. Between the interval, patients are completely free. Trigger zone: It is the area where the pain is more severe. Trigger zones are stimulated by factors such as shaving, washing, eating, etc,.[Figure: 1]“Half an inch finger test” is positive, the patient avoids touching the face to point the trigger zone.
Facial palsy: Dysfunction of the facial nerve which will cause paralysis of facial muscle. Features: Loss of wrinkles in forehead; inability to close eye, drooping of the angle of the mouth, epiphora – an overflow of tears, drooling of saliva, retention of food in the mouth, inability to raise the eyebrow. [Figure: 2]
Glossopharyngeal neuralgia: Pain along the course of the Glossopharyngeal nerve. Features:Affects the throat, ear, and posterior one-third of the tongue and pharynx. Triggers: Provoked by swallowing, talking, and chewing.
Sphenopalatine neuralgia: Also called the “alarm clock headache”. Pain occurs on one side of the face, more concentrated in the region of the eye. Symptoms: Sharp, steady pain, and burning sensation. Pain lasts for 15mins to 3 hours if left untreated.
Postherpetic neuralgia: Complication of herpes zoster (viral infection) seen in elderly patients. [Figure: 3] The neuralgic pain persists for weeks to months even after the resolution of the viral rashes. This persistent pain is because of the swelling or thickening of the affected nerve which causes continuous pain and burning sensation.
Ramsay Hunt Syndrome: Special form of Herpes Zoster (viral infection) affecting facial nerve via geniculate ganglion. Features: Unilateral pain affecting the tongue, soft palate; the appearance of blisters in the ear region which breaks to form ulcers; facial palsy; loss of taste sensation. [figure:4]
About the Author
This article has been contributed by the Department of Oral Pathology & Microbiology, Yenepoya Dental College under the Yenepoya (Deemed to be University) established in the year 1992, with its robust alumni of 3000 Undergraduates and 67 Postgraduates students and research scholars has many accolades and achievements to its credit. It strives to provide state of art Oral diagnostics and Molecular Pathology while excelling in research activities and instilling a holistic approach in dental education among students. Department contributes its expertise in fostering interdisciplinary collaboration and providing exemplary education and research.