The cheek is the side part of the human face, which is innervated by the buccal (buccal) nerve, and is also the outer side wall of the oral cavity. Pain in this area can be caused by various reasons. Most often it is associated with dental diseases (caries, periodontitis, pulpitis and others).
Why do my cheeks hurt?
There are several reasons why your cheek may hurt:
- Sinusitis - the pain is less pronounced in the morning and intensifies in the evening. Unpleasant sensations are not concentrated in one place and are perceived by the patient as a general headache;
- Trigeminal neuralgia (trigeminal neuralgia) is a chronic disease that affects the trigeminal nerve, which is manifested by intense paroxysmal pain in the areas of innervation of the branches of the trigeminal nerve. This disease most often affects women over 40 years of age. In this case, the cheek usually hurts severely on only one side; rarely, the disease affects both halves of the face. The pain is very strong, shooting, the duration of the attack is usually 10-15 seconds, but can reach two minutes and is accompanied by uncontrollable lacrimation and increased salivation;
- Ernest's syndrome - this disease has symptoms similar to trigeminal neuralgia. It is observed when the stylomandibular ligament, which connects the base of the skull with the lower jaw, is damaged. At the same time, the cheek, neck, face, head hurt;
- Temporal tendonitis - this disease is accompanied by unpleasant sensations that affect the teeth, cheek and neck area;
- Dental diseases - advanced caries, pulpitis or periodontitis often lead to severe pain in the cheek on the side of the damaged tooth.
Swelling of the cheek
Most often, pain in the cheek is associated with teeth, but situations are also possible when the cheek is swollen, but the tooth does not hurt. The cause may be an ear disease or inflammation of the parotid gland, so you may need to consult with several specialists to determine the true cause of the swollen cheek.
It should be remembered that swelling of the cheek, even if there is no pain, is a reason to consult a doctor. Inflammatory processes in the body can develop very slowly, but when the disease is advanced, it is much more difficult to cope with its consequences.
What to do when your cheek hurts
To find out why your cheeks hurt, you first need to see a dentist. If the causes of discomfort are not related to teeth, he will refer you for examination to an otolaryngologist or neurologist.
Treatment for cheek pain depends on the cause that caused it. If the cheek is swollen as a result of gumboil, surgical intervention will be required. To treat inflammatory diseases, doctors prescribe antibacterial drugs, painkillers, as well as local therapy: cold compresses, rinses, etc.
Pre-medical measures
If your cheek hurts, before visiting the dentist you can take some measures to alleviate the condition:
- Apply ice, a cold compress, or a bandage to the affected area;
- Take an analgesic;
- Rinse your mouth 3-4 times a day with a warm solution of antiseptic drugs, a salt solution or a decoction of herbs that have an anti-inflammatory effect.
Under no circumstances should you apply warm compresses to the painful area, as this may trigger the onset of a purulent process. You should also not take antibiotics without a doctor's prescription.
To prevent cheek pain, you should practice good oral hygiene. During the cold season, it is important to keep your face warm, as hypothermia can cause sinusitis and other inflammatory diseases of the ear, nose and throat.
Video from YouTube on the topic of the article:
The triadic nerve consists of three branches that arise from the brain stem and spread out of the skull through three different foramina. They reach the surface of the face and supply it with nerves, thereby ensuring continuous communication with the central nervous system.
The first branch is located symmetrically and the exit points are located slightly above the eyebrows. As for the second branch, it is located below the eyes on both sides of the nose in the cheek area. Well, the third branch is located in the lower area of the jaw and spreads from the corners of the mouth, heading towards the center.
In the medical literature, inflammation of the trigeminal nerve is called “trigeminal neuralgia.” A person who suffers from trigeminal neurology experiences indescribable pain.
Causes of inflammation of the ternary nerve
The triadic nerve may be affected by a meningioma, neuroma, or scarring in the brain stem. There are times when the pressure on the brain stem provokes vasodilation or sclerotic changes in the arteries. The nerve may be damaged due to a bacterial or viral infection.
Trinitarian neuralgia occurs extremely rarely and, as a rule, occurs in women who are between the ages of 50 and 69 years. Inflammation of the ternary nerve in young men is a consequence of sclerotic changes in the body.
Manifestation of pain during inflammation of the ternary nerve
Patients, as a rule, feel spontaneous, which can be compared to an electric current discharge, since it manifests itself, on the one hand, and has a shooting character. It is worth noting that pain appears superficially. They do not penetrate deeply, are moderate or very strong. Painful attacks last no more than two minutes, but patients are sure that this goes on forever. Attacks of pain are very difficult to bear, as they are repeated several times during the day.
In each patient, pain is provoked by different factors. As a rule, this can be any facial movement, smile, shaving, conversation, etc. light touch, eating and even brushing teeth. Patients try not to provoke pain attacks, which is why they try to exclude pain-provoking factors from their diet. Such actions significantly worsen the quality of life. Sometimes a long time passes between attacks of pain, which can even last several months.
Pain is localized and distributed according to the areas of innervation of one or two nerve branches.
Painful attacks in the area of the ophthalmic nerve (first branch) radiate to the eyes, temples and forehead.
Painful attacks in the area of the maxillary nerve (second branch) can be felt in the upper jaw, upper teeth, upper lip, cheeks in the area below the eyes.
Pain attacks in the area of the mandibular nerve (third branch) are felt in the lower jaw, lower lip and lower teeth.
Facial pain can be caused by chickenpox, herpes, or another virus that damages the trigeminal ganglion. The first signs of the disease include increased body temperature, redness of the face and increased sensitivity on one side of the face.
Particular attention should be paid to any rashes on the face. The disease can also affect the cornea of the eye or the mucous membrane of the soft palate. Changes can occur even within two months, and if timely treatment is not started, this can lead to long-term painful attacks that will last for several years, or even a lifetime. If you have the above symptoms, you should immediately consult a doctor and begin treatment.
How to understand that it is the ternary nerve that is inflamed?
The main three branches of the triangular nerve have branches throughout the face. Inflammation of the small branches of the main nerves also provokes. Sometimes these attacks of pain are very difficult to distinguish from the symptoms of other diseases.
Nasociliary nerve arises from the first branch and innervates the frontal sinus, bridge of the nose and eyeball. Damage to this nerve due to facial trauma or sinus disease causes acute pain in the frontal and nasal region that lasts several hours. The eyes may also become watery. Constant aching and dull pain is observed between painful attacks.
The superior alveolar nerve arises from the second branch and innervates the gums and upper teeth. This nerve is very often damaged due to jaw injuries or dental procedures. If this particular nerve is inflamed, then pain will not occur due to temperature changes. In other cases, sharp pain will occur in the gums and upper teeth, and between attacks there is a dull pain.
The mandibular nerve arises from the third branch. Its irritation or damage can be caused by injuries to the jaw or surgery, as well as the removal of lower teeth.
Patients feel pain in the lower lip, and sometimes in the ears and chin. The pain manifests itself more intensely, so after attacks of pain, patients feel dull pain. Changes in temperature are not provoking factors in these cases.
Poorly made dentures for teeth, facial injuries, inflammation of the maxillary cavities can cause injuries to the buccal nerve, which comes off from the third branch, innervating the skin of the corners of the mouth, gums and buccal mucosa. The patient feels moderate pain in the temples and cheek area.
Damage to the lingual nerve causes unpleasant pain. It arises from the third branch and innervates the first two-thirds of the tongue. Damage can occur due to oral trauma, improperly made dentures, or sharp tooth edges. As a result of such damage, acute pain occurs with a simultaneous burning sensation. The patient's tongue also becomes numb and salivates profusely. The pain is more intense when talking, as well as when eating or drinking cold water.
The third branch also divides into the auriculotemporal nerve, which innervates the skin of the temporal region, part of the external ear, the external auditory canal and the parotid gland. Any disease associated with this branch provokes attacks of pain in the temporal region and deep in the ear.
When the glossopharyngeal nerve is affected by pressure from scarring, sclerotic lesions of the arteries, or other processes occurring in nearby tissues, these changes provoke severe pain that travels through the throat and the root of the tongue. Sometimes pain is felt in the ears, eyes and jaw. The attack of pain intensifies while eating and swallowing food, as well as when talking. Painful attacks can last for several days and are simply unbearable for the patient. Between attacks, patients feel a dull pain at the root of the tongue.
Not just the trigeminal nerve
Attacks of facial pain provoke damage to other neural structures. An obvious example is tonsillitis, inflammation of the paranasal sinuses and other processes that can cause damage to the autonomic ganglion. The symptoms are reminiscent of facial neuralgia, and causes pain in the eyes, teeth, face, root of the nose, base of the skull and temples. Patients often hear ringing and noise in the ears.
Due to trauma, dental treatment and tonsillitis, the autonomic ganglion, which is localized below the lower jaw, can be provoked. When it is damaged, the patient experiences dull and simultaneous pain. For 10-15 minutes, acute pain may occur in the area below the jaw, which is accompanied by profuse salivation and swelling of the tongue. Painful sensations can be provoked by palpation triangle under the lower jaw.
Sometimes, due to a lack of data, trigeminal nerve pain is confused with superior cervical sympathetic ganglion syndrome. Unlike inflammation of the ternary nerve, this syndrome occurs due to pathologies of the lymph nodes, lungs, spine and other surrounding tissues.
In the case of the syndrome, the pain is localized in the entire face. The patient also experiences burning and acute pain in the teeth and mouth. On the affected side of the face, sensitivity increases, with a simultaneous reduction in the pupil and drooping of the corresponding eyelid. The patient develops tachycardia, and changes in blood pressure increase.
Treatment of inflammation of the ternary nerve
The classic symptoms of trigeminal neuralgia include short-term, shooting, superficial, severe pain followed by periods of its absence. But sometimes the symptoms of the disease resemble otolaryngological or dental diseases that arise due to damage branches of the main branches of this nerve. Therefore, if the doctor does not find any pathology, the patient should consult a neurologist. For effective treatment, it is very important to know the cause of the pain, so the doctor may prescribe a computer scan, magnetic resonance imaging, or angiography.
In some cases, treatment of the trigeminal nerve does not produce results. Therapy only reduces pain, thereby alleviating the patient's suffering. In all other cases, treatment gives a positive result only if specially selected combinations of medications are used.
Sometimes doctors prescribe surgical intervention, which has a therapeutic effect. Reflexology and therapeutic blockades are also prescribed.
VIDEO
We treat inflammation of the ternary nerve using traditional medicine
Elderberry for inflammation of the ternary nerve
The facial nerve is connected to the nerve plexuses and arteries. Many nerve plexuses lead to it from the oral cavity, ear canal, back of the head, temporal artery and other parts of the face. Medical practice shows that women in adulthood suffer from facial nerve disease. They begin to feel severe pain on the side of the face in the area facial nerve. For the first time, ice applied to the affected area helps, but this will only relieve the pain for a while. These painful attacks will recur more and more often.
For facial paralysis, it is very useful to use elderberries for treatment. All you need is elderberry puree. It only takes a few minutes to prepare this product. First, take the berries and steam them a little, and then chop them. A compress of berry puree should be made twice a day, morning and evening.
Japanese Shiatsu massage in the treatment of the trigeminal nerve
To treat inflammation of the facial nerve, Japanese Shiatsu massage is very effective. With its help, you can relieve fever and fatigue from the facial nerves, without additional costs for medications. There are eight points on the face and neck. In order to remove heat from the main points of the nerve branches, you need to apply pieces of ice to these points. Before you start wiping your face with ice, you need to put on gloves. The points are massaged in order.
Point No. 1– located above the eyebrow.
Point No. 2– located above the eye.
Point No. 3- located under the cheekbone.
Point No. 4– located on the edge where the wing of the nose is.
Point No. 5– between the chin and lower lip.
Point No. 6- on the temples.
Point No. 7- in front of the ear.
Point No. 8- on the back of the neck.
The neck must be massaged on both sides of the spine, going lower. All actions are performed by rotational movements of the ice. At the eighth point you need to stop for 10 seconds and wait. It is worth noting that each point requires the same amount of time. Once you have completed all the manipulations with ice, take off your gloves and touch the massaged points with your hands. Then put on gloves and repeat the massage of each point using ice.. Then warm up the points again. These steps need to be repeated three times, after which you will feel relief. It is temperature changes that help reduce pain attacks.
Treating facial paralysis with dates
There is a huge chance that if the base of the facial nerve is damaged, part of the face will be paralyzed. The following traditional medicine recipe will help you get rid of facial paralysis. The beauty of this recipe is that it also treats stroke. All you need is a meat grinder and dates..
Take ripe dates and peel them and remove the pits. Then pass the prepared dates through a meat grinder, and that’s it. To obtain a positive effect from the treatment, this remedy should be taken three times a day, three teaspoons. If you find it difficult to take, the medicine can be diluted with milk or any other liquid. The course of treatment with traditional medicine consists of one month.
Trigeminal neuralgia is a chronic inflammatory disease of the trigeminal nerve (the largest sensory nerve of the face), characterized by paroxysmal pain syndrome.
This disease is also called facial or trigeminal(from Latin trigeminus or trigeminal) neuralgia.
Some statistics!
Trigeminal neuralgia occurs in 40-50 cases per 100 thousand population, about 5 people per 100 thousand population fall ill annually.According to statistics, women over 50 years of age are more often affected. Young people are less likely to get sick; a few cases of the disease have been described in preschool children.
Some interesting facts!
- The first descriptions of trigeminal neuralgia are found in ancient sources. Thus, the Chinese healer Hua Tuo was the first to use acupuncture for this disease, but this procedure did not cure, but only temporarily eliminated the pain syndrome. Hua Tuo was executed by the ruler of the Chinese Empire, who suffered from this disease, because the doctor was not with him during the onset of an attack of facial pain. This pain was so unbearable for the commander.
- Trigeminal neuralgia refers to idiopathic diseases, that is, diseases with an unknown cause. There is a lot of controversy among scientists about what leads to this disease, but a consensus has not yet been found.
- Manifestations of trigeminal neuralgia can resemble toothache, so dentists are often the first to see this condition. In this case, patients indicate pain in a completely healthy tooth; such a tooth may be mistakenly removed.
- Stressful situations and surgical interventions on the face and oral cavity contribute to a temporary (up to several months) subsidence of the pain syndrome with trigeminal neuralgia.
- Conventional non-narcotic analgesics are not effective in the treatment of neuralgia, they can only temporarily reduce pain, and with each dose they help less and less.
- Frequent attacks of unbearable pain due to trigeminal neuralgia can disrupt the patient’s mental state, leading him to depression, fear, aggressive states, and psychosis.
- An attack of pain with trigeminal neuralgia can be caused by even a light touch, for example, applying cream to the face.
How do nerves work?
Nervous system– one of the most important and complex systems of the body, which regulates, controls and carries out all processes occurring in the human body. We cannot do anything: neither move, nor think, nor show emotions, nor breathe, nor resist foreign agents, and we are not even able to reproduce without the participation of the nervous system.The human nervous system, especially the brain, has not yet been fully studied and is a treasure trove for new discoveries and Nobel Prizes. After all, it is almost impossible to predict a person’s reaction to various stimuli at one time or another, to even fully imagine a person’s capabilities, to understand the compensatory and restorative capabilities of the brain after injuries, infections and other pathological conditions of the nervous system.
And the most important human function, carried out by the nervous system - intelligence, distinguishes and exalts us above other creatures of planet Earth. A huge number of scientists are working on the creation of artificial intelligence, but at the moment this is not possible; the human nervous system is thought out by nature to the smallest detail and is unique.
Structure of the nervous system
Central nervous system
The central nervous system in humans is represented by brain and spinal cord.Main functions of the central nervous system:
- regulates the functioning of all organs and systems, coordinates their joint synchronous work,
- ensures an adequate response of the body to various factors of the world around us,
- the implementation of mental functions, reason, thinking, emotions and so on, which distinguishes us humans from other creatures.
- bark brain,
- cerebral hemispheres brain (telencephalon),
- diencephalon: thalamus, hypothalamus, epithalamus, pituitary gland,
- midbrain: roof of the midbrain, cerebral peduncles, aqueduct of the midbrain,
- hindbrain: pons, cerebellum, medulla oblongata.
Rice. Schematic representation of the main structures of the brain.
Peripheral nervous system
Peripheral nerves include cranial and spinal nerves.Main functions of the peripheral nervous system:
- collection of information from the environment, as well as about the internal state of human systems and organs,
- transmission of impulses with information to the central nervous system,
- coordination of the work of internal organs,
- making movements,
- regulation of the functions of the circulatory system and others.
- Somatic nervous system– carries out movements and collects information from outside and inside.
- Autonomic nervous system:
- sympathetic nervous system - activates at times of stress, danger, reaction to environmental and internal environmental factors;
- parasympathetic nervous system – activates during rest, rest and sleep;
- enteric nervous system – responsible for the functioning of all parts of the gastrointestinal tract.
According to their functions, cranial nerves can be divided into:
- sensory nerves– are responsible for the perception and transmission of nerve impulses to the brain by the senses (hearing, vision, smell, taste, sensitivity of the skin and mucous membranes);
- motor nerves– responsible for muscle function;
- mixed nerves– nerves that have sensory and motor functions.
*Cranial nerve nuclei- these are formations of the nervous system that receive and transmit nerve impulses to the peripheral nervous system, namely the cranial nerves.
Nerves under a microscope
Neuron (nerve cell or neurocyte)- is a structural unit of the nervous system, these cells are highly specialized, capable of reproducing and transmitting nerve impulses, which in their characteristics are very similar to electrical ones.Neurons vary in size depending on function and type, on average from 10 to 30 µm (minimum 3, maximum 120 µm).
“Nerve cells do not recover!” - truth or myth?
How many times have each of us heard this expression from doctors, teachers, parents. But in 1999, American scientists partially debunked this myth. Elizabeth Gould and Charles Gross proved that the central nervous system produces thousands of new neurons every day throughout life, they suggest that due to these new cells, a person’s memory improves, new skills and knowledge emerge. That is, these are sheets of white paper on which each person writes down something new for himself. Research is still being carried out in this direction; no one knows where it will lead the scientific world, but most likely these studies will change our understanding of the functioning of the nervous system. And, perhaps, new discoveries will help find effective treatments for diseases that are currently considered irreversible, such as multiple sclerosis, Parkinson's disease, Alzheimer's syndrome and others.Structure of neurons
What does a neuron consist of?- Dendritic processes– receive impulses from other cells, usually have a branched shape (like a tree, each branch is divided into branches). A neuron usually contains a large number of dendrites, but in some cells this process can be single (for example, retinal neurons that transmit impulses to the photoreceptors of the eye).
- Neuron body (soma) with the nucleus and other organelles. The body of the neuron is covered by two layers of fat (lipid membrane), a protein layer and an accumulation of polysaccharides (carbohydrates). Thanks to this structure of the cell membrane, the body of the neuron is capable of processing nerve impulses, and impulse accumulation occurs in it.
Soma also provides nutrition to the cell and the removal of waste products from it. - Axon hillock- a section of the neuron body from which the neuron axon extends; the function of this structure is to regulate the transmission of a nerve impulse to the axon, that is, excitation of the axon.
- Axon process- a long process through which information is transmitted to other neurons. Each neuron has one axon; the longer it is, the faster the nerve impulse is transmitted. The terminal sections of the axons are divided into terminal branches; they are the ones that connect to other nerve cells. An axon may be covered with or without a myelin sheath.
- Myelin sheath is an insulator of electricity; it is a membrane consisting of lipids and proteins. It consists of glial cells (Schwann cells in the peripheral nervous system and oligodendrocytes in the central nervous system), spirally enveloping the axon. Between the glial cells there are gaps - the interceptions of Rwanje, which are not covered with myelin. Thanks to myelin, electrical impulses are transmitted quickly along the nerves.
Types of neurons, depending on the functions performed:
- motor neurons – transmit impulses from the central nervous system to the peripheral nerves of the muscles,
- sensory neurons - convert impulses from the surrounding or internal environment and transmit them to the central nervous system,
- interneurons – neurons that transmit impulses from one neuron to another, mainly interneurons are represented by nerve cells of the central nervous system.
Nerve fibers– axons of neurons.
Nerve– accumulation (bundles) of nerve fibers.
Neuron connections
Neurons connect to each other to form synapses. Through them, one nerve cell (transmitting) transmits a nerve impulse to another nerve cell (receiving). A synapse can also connect a nerve cell with cells of innervated tissue (muscle, gland, organ).
The brain and spinal cord are a vast collection of interconnected neurons that have an extremely complex relationship.
Components of a synapse:
- Transmitting neuron axon(its presynaptic ending) is capable of stimulating the production of special chemical transmitters - transmitters. Mediators of the nervous system (neurotransmitters, neurotransmitters) are produced in synaptic vesicles of the presynaptic terminal.
- Synaptic cleft, an impulse is transmitted through it.
- Receptive part of the cell– or receptors on any receptive cell. Receptors can be located in the dendrite, axon or body of a neuron, on the membrane of sensitive cells of muscles, internal organs, sensory organs, glands, and so on.
Groups of neurotransmitters (neurotransmitters):- Monoamines: histamine, serotonin;
- Amino acids: Gamma-aminobutyric acid (GABA), glycine, glutamic and aspartic acids;
- Catecholamines: adrenaline, norepinephrine, dopamine;
- Other neurotransmitters: acetylcholine, taurine, ATP, etc.
How is a nerve impulse transmitted?
Nerve impulse– this is natural electricity that passes through electrical wires (nerves) in different directions and along certain trajectories. This electricity (impulse) is of chemical origin, carried out with the help of nervous system mediators and ions (primarily sodium and potassium).Stages of formation and transmission of nerve impulses:
- Excitation of a neuron.
- Turning on the sodium-potassium pump, that is, sodium moves into the excited cell through special sodium channels, and potassium moves out of the cell through potassium channels.
- Formation of a potential difference between the synapse membranes (depolarization).
- Formation of a nerve impulse - action potential.
- Transmission of nerve impulses along nerve fibers through synapses:
- secretion of neurotransmitters in synaptic vesicles of the transmitting terminal,
- release of mediators (or substances that destroy them - in the process of inhibition) into the synaptic cleft,
- stimulation of depolarization of the receiving cell (opening of sodium and potassium channels) - during excitation of the nerve fiber, or hyperpolarization (closing of sodium-potassium channels) during inhibition ** ,
- transmission of the impulse further along the nerve fibers to the central nervous system or innervated organ.
The speed of transmission of nerve impulses along nerve fibers covered with myelin is 2-120 m/s.
In addition to the transmission of nerve current through synapses, it is possible to directly propagate an impulse by contact, without the participation of mediators, with a dense arrangement of nerve cells.
Interesting! You can watch the video: “The incredible is all around us. Nervous system".
Reflex– this is the body’s reaction to any irritant from inside or outside the body. The central nervous system is necessarily involved in this process.
Reflex is the basis for the functioning of the nervous system; almost all nervous processes occur with the help of reflexes.
During the reflex process, a nerve impulse passes through a reflex arc:
- receptors of certain cells, organs and tissues,
- sensory nerve fibers form and transmit nerve impulses from innervated organs,
- analysis of impulses in the central nervous system,
- motor nerve fibers transmit impulses to innervated organs - a response to a stimulus.
- conditional,
- unconditional.
These reflexes develop as an automatic reaction to external and internal factors. Unconditioned reactions exercise a person’s ability to self-preserve, adapt to environmental conditions, reproduce, and maintain homeostasis - the constancy of the internal state of the body. They are genetically determined and passed on from generation to generation.
Examples of unconditioned reflexes: sucking breast milk by a newborn baby, sexual, maternal and other instincts, blinking when there is a threat of eye injury, coughing and sneezing when foreign particles enter the respiratory tract, and so on.
Trigeminal nerve
The trigeminal nerve is the fifth pair of cranial nerves. It got its name due to the presence of three branches:- ophthalmic (superior) branch,
- maxillary (middle) branch,
- mandibular (lower) branch.
Characteristics of the trigeminal nerve
| Options | Characteristic | ||
| Optic nerve | Maxillary nerve | Mandibular nerve | |
| Type of nerves | Sensitive | sensitive | mixed nerve, contains sensory and motor fibers |
| What does it innervate? |
| Skin of the eyelid (lower), upper lip and side of the face, upper teeth |
|
| Basic functions | Skin sensitivity, regulation of tear production, sensitivity of the meninges | Skin sensitivity |
|
| Place of exit from the skull | Outer wall of the orbit. | round hole - located under the eye socket. | Foramen ovale – located under the eye socket. |
| Main branches of the nerve |
|
|
|
| Nerve ganglia** formed by the trigeminal nerve | Eyelash knot:
| Pterygopalatine node:
| Ear node:
|
| Nuclei in the brain | Motor fibers trigeminal nerves are located in the pons (hindbrain) – motor nuclei of the trigeminal nerve. Sensitive fibers The trigeminal nerve passes through the cerebral peduncles and is represented by sensory nuclei in the brain:
|
||
***Nerve nodes or ganglia- an accumulation of nervous tissue containing nerve fibers and nerve centers, connects two or more nerve fibers, receives impulses both from the endings and from the central nervous system (ascending and descending flows).
Rice. No. 1: Ophthalmic and maxillary nerve and their branches.
Rice. No. 2: Mandibular nerve and its branches.
Causes of trigeminal neuralgia
According to the mechanism of occurrence of trigeminal neuralgia, this pathology can be primary or true (isolated damage to only the trigeminal nerve) or secondary (manifestation of neuralgia as a symptom of systemic diseases of the nervous system).The exact cause of the development of trigeminal neuralgia is not clear; as mentioned above, it is an idiopathic disease. But there are factors that most often lead to the development of this disease.
Factors that contribute to the development of trigeminal neuralgia:
- Compression of the trigeminal nerve in the cranium or its branches after leaving the skull:
- cerebral vasodilatation: aneurysms (pathological dilatations of blood vessels), atherosclerosis, hemorrhagic and ischemic strokes, increased intracranial pressure as a result of osteochondrosis of the cervical spine, congenital anomalies of vascular development and so on - the most common cause of the development of trigeminal neuralgia,
- tumor formations brain or facial area along the branches of the trigeminal nerve,
- injuries and post-traumatic scars,
- injuries in the area of the maxillotemporal joint,
- connective tissue proliferation(adhesions) as a result of an infectious inflammatory process, sclerosis with damage to the myelin sheath of nerve fibers.
- congenital anomalies development of bone structures of the skull.
- Viral nerve lesions: herpes infection, polio, neuro-AIDS.
- Nervous system diseases:
- multiple sclerosis,
- infantile central palsy (CP),
- meningitis, meningoencephalitis (viral, tuberculous),
- encephalopathy due to head injuries, infectious processes, hypoxia (lack of oxygen in the brain), lack of nutrients,
- brain tumors and circulatory disorders in the area of the nuclei and fibers of the trigeminal nerve, and so on.
- Odontogenic causes(teeth related):
- “unsuccessful” filling or tooth extraction or other surgical interventions in the face and oral cavity.
- reaction to anesthesia of dental canals,
- jaw injury with damage to teeth,
- dental flux
Factors that increase the risk of developing trigeminal neuralgia:
- age over 50 years,
- mental disorders,
- chronic fatigue,
- stress,
- hypothermia of the face (for example, in a draft),
- avitaminosis (lack of B vitamins),
- metabolic disorders: gout, diabetes, thyroid diseases and other endocrine pathologies,
- helminthiasis (worms),
- starvation, impaired absorption of nutrients in the intestines, bulimia, anorexia,
- inflammation with swelling of the mucous membrane of the maxillary and other paranasal sinuses (chronic sinusitis),
- inflammatory processes and ulcers (abscesses, phlegmons) in the oral cavity - gingivitis, pulpitis,
- suppuration of the skull bones, especially the jaws (osteomyelitis),
- acute and chronic infectious diseases with severe intoxication: malaria, syphilis, tuberculosis, brucellosis, botulism, tetanus and so on.
- autoimmune diseases,
- severe allergic diseases.
Mechanism of development (pathogenesis) of trigeminal neuralgia
The pathogenesis of the development of trigeminal neuralgia has been debated by many scientists around the world for many years. Depending on the reasons that contributed to the occurrence of trigeminal neuralgia, two theories of the mechanism of its development:
And although there are “dark spots” in each theory, it is assumed that both mechanisms for the development of pain syndrome take place, that is, they follow each other sequentially. That is why treatment of trigeminal neuralgia should be comprehensively aimed at restoring the myelin sheath of nerve fibers and inhibiting nervous processes in the brain.
Symptoms of trigeminal neuralgia
The main symptom of trigeminal neuralgia is pain in the face, but there are other manifestations and complications of this disease that do not cause such discomfort as unbearable pain, but may additionally indicate trigeminal neuralgia.| Symptom | How does it manifest? | When does the symptom occur? |
| Facial pain | Pain syndrome usually manifests itself in only one half of the face. The pain is paroxysmal or it is also called paroxysmal; attacks are replaced by periods of calm. The pain is unbearable, shooting in nature, and is often compared to electric shock. At these moments, the patient freezes in the position in which the attack began, tries not to move, and clasps his hands at the location of the pain. Attacks of pain usually last from a couple of seconds to several minutes. Quiet periods can range from a few hours to several months. Sometimes, with an atypical course or an advanced long-term course of the disease, pain in the face and head is almost constant. With the duration of the disease, the duration of attacks increases, and the period of remission shortens. |  Pain usually appears after exposure to irritating factors. There are zones on the face, so-called trigger zones (in the literature you can find the term algogenic zones), with slight irritation of which a painful attack can begin. Moreover, rough influence on these points during an attack often leads to its relief (cessation). Localization of trigger points is individual:
 Rice. Possible trigger zones for trigeminal neuralgia. |
Localization of pain****
| With damage to the ophthalmic branch of the trigeminal nerve. | |
| With damage to the maxillary branch of the trigeminal nerve. | |
| With damage to the mandibular branch of the trigeminal nerve. | |
| With damage to all branches of the trigeminal nerve and with the central cause of neuralgia (brain tumors, etc.).  |
|
| Redness of the face and sclera, increased salivation, lacrimation, mucous discharge from the nose | These symptoms are localized on the affected side and appear during a painful attack. | Facial hyperemia and increased production of the salivary, lacrimal glands and nasal mucous glands are associated with disorders of the autonomic nervous system, the branches of which are part of the sensory fibers of the branches of the trigeminal nerve. |
| Twitching of facial muscles | Muscle tremors are similar to mild local convulsions or nervous tics and occur against the background of pain. In this case, chewing and facial muscles are involved. There may be a narrowing of the palpebral fissure on the affected side, associated with spasm of the eyelids. | Muscle twitching is associated with a reflex spread of increased excitability to the motor fibers of the trigeminal nerve and other cranial nerves innervated by the facial muscles.  Photo of a patient during an attack of trigeminal neuralgia. |
| Mental disorders | The patient becomes irritable, feelings of fear and anxiety appear. When laughing, talking, or eating leads to the development of pain, the patient withdraws, remains silent, and refuses to eat. In severe cases, suicidal tendencies (desire to commit suicide) may occur. | Mental disorders in the patient arise against the background of frequent debilitating attacks of unbearable pain, the duration of the disease (years), the occurrence of attacks against the background of minor factors irritating trigger zones. Patients develop apathy, psychosis, phobias, depression, and so on. |
| Loss of facial sensitivity (paresthesia) | A feeling of tingling, crawling on the affected side. A dull aching pain may appear, reminiscent of toothache due to caries and pulpitis (which brings patients to the dentist). Sometimes there is a lack of skin sensitivity along the branches of the trigeminal nerve. | This symptom occurs in a third of patients and is usually a harbinger of an upcoming painful attack (several days or several months before the paroxysm). Paresthesia is associated with widespread damage to the myelin sheath of nerve fibers, which leads to disruption of their sensitivity in the direction of increased excitation and disruption of the conduction of nerve impulses along the sensitive nerve fibers. |
| Impaired blood circulation and lymphatic drainage (trophic changes) |
| Trophic disorders along the trigeminal nerve can occur after several years of illness. Due to a violation of the innervation of the muscles and skin of the face by the trigeminal nerve, prolonged and frequent pain attacks, there is a violation of blood circulation and lymph flow on the affected half of the face. This leads to tissue malnutrition (lack of oxygen and nutrients). In order not to irritate trigger zones, the patient spares the painful side of the face: chews on the healthy side, does not smile, does not open his mouth wide, and so on. Over time, this leads to atrophy of the chewing and facial muscles (reduction of muscle tissue, decrease in their functions), which in turn also leads to impaired trophism of the muscles and skin of the face.  Photo of a patient with atrophy of the facial muscles on the right side. |
****Trigeminal neuralgia usually develops on one side and is most often right-sided. As the disease progresses, the location of the pain does not change. Only with severe pathologies of the brain is it possible over time for the process to spread to the second half of the face.
Diagnosis of trigeminal neuralgia
Examination by a neurologist
- Anamnesis (history) of life: the presence of factors and diseases that could cause trigeminal neuralgia (tumors, vascular pathology of the brain, previous diseases, surgical interventions in the oral cavity or on the face, and so on).
- History of illness:
- the onset of the disease is acute, sudden, patients clearly remember when, where and under what circumstances the first attack of paroxysmal pain began,
- attacks of pain alternate with periods of remission,
- pain syndrome provokes even slight irritation of one of the trigger zones of the trigeminal nerve,
- one-way process
- pain is not relieved by anti-inflammatory and analgesic drugs.
- Complaints for attacks of acute unbearable pain that appears suddenly after irritation of trigger zones, and the appearance of other symptoms of trigeminal neuralgia (shown in the table above).
- Objective examination during the interictal period:
- General condition usually satisfactory, consciousness is preserved, neurotic reactions and disturbances in the patient’s mental state are possible.
- Upon examination of the patient won't let you touch your face in the area of trigger zones, he himself points to them, without bringing his finger to the skin or mucous membrane.
- The skin is often unchanged, with a severe long-term course of the disease, dry skin, the presence of peeling, folds and wrinkles, facial asymmetry, drooping of the upper eyelid and other symptoms of facial muscle atrophy are possible. Visible mucous membranes are not changed.
- Sometimes there is a disturbance in the sensitivity of the facial skin (paresthesia).
From the internal organs(cardiovascular, respiratory, digestive and other body systems) usually no pathological changes are detected during the examination. - Neurological status in patients with trigeminal neuralgia without pathology of the central nervous system, it is not changed. There are no pathological reflexes or signs of inflammation of the meningeal membranes (meningeal signs).
- Objective examination of the patient during an attack of paroxysmal pain:
- Pain occurs after exposure to the trigger zones of the trigeminal nerve, and the pain syndrome itself spreads only along the branches of the trigeminal nerve.
- Patient position: freezes or tries to stretch his facial muscles with his hands, does not answer questions or answers in short phrases. The patient looks very frightened and suffering.
- On the skin perspiration (sweat) appears on the face, the skin of the affected side of the face and the mucous membrane of the sclera turns red, lacrimation is possible, the patient often swallows due to increased saliva secretion, mucous discharge may appear from the nose in a stream.
- Possible appearance convulsive twitching facial muscles on one side.
- Breath the patient's blood pressure decreases or becomes more frequent.
- Pulse becomes more frequent (more than 90 per minute), blood pressure does not change or increases slightly. By pressing on the trigger points of the trigeminal nerve, the attack of pain can be temporarily stopped.
- When conducting novocaine blockade trigeminal nerve (introduction of novocaine along the branches of the trigeminal nerve, basically these are the trigger points) the attack temporarily stops.
The diagnosis is made on the basis of specific complaints, the presence of trigger zones, localization of pain along the branches of the trigeminal nerve, the appearance of the above symptoms during an attack, an objective examination, and instrumental diagnostic data.
Instrumental research methods
Magnetic resonance imaging (MRI) of the brain and spinal cord MRI– most informative a method for studying the structures of the brain, its vessels, nuclei and branches of cranial nerves.
This method is visual (that is, we get an accurate three-dimensional image on the screen and on paper), however, unlike X-ray methods, MRI is based on magnetic rather than radiation. That is, it is safe for the patient.
If trigeminal neuralgia is suspected, MRI is necessary to identify or exclude brain tumors, vascular disease, the presence of diffuse or multiple sclerosis and other possible causes of the disease.
For a more accurate study of pathologies of cerebral vessels, MRI is used with the introduction of a contrast agent into the vessels (angiography).
Disadvantages of the method:
- high cost of research;
- contraindications: the presence of metal objects in the body (remnants of fragments, pacemakers, metal plates that are used for osteosynthesis for complex bone fractures, metal dentures, crowns), severe psychological illnesses, claustrophobia.
Computed tomography (CT) CT– an x-ray diagnostic method that allows layer-by-layer visualization of the structures of the brain and spinal cord. In terms of information content, it is slightly inferior to magnetic resonance imaging, since MRI allows you to create a three-dimensional image, and CT allows you to create a two-dimensional image. CT can identify diseases of the central nervous system that could lead to the development of trigeminal neuralgia.
The main disadvantage of computed tomography is the high radiation exposure and high cost (but the CT method is more accessible and cheaper than MRI). 
Electroneurography
Electroneurography – an instrumental method for studying the nervous system that allows one to determine the speed of electrical current (impulse) along the nerve fibers of peripheral nerves.
What does electroneurography reveal?
- the presence of nerve damage,
- level of damage (that is, where exactly),
- pathogenesis of the lesion (damage to the myelin sheath or damage to the axon),
- prevalence of the process.
- demyelination(damage to the myelin sheath of axons), which is a key factor in the pathogenesis of trigeminal neuralgia,
- other nerve changes, characteristic of other nerve lesions, allowing to differentiate diseases of the nervous system.
Electroneuromyography (ENMG)
ENMG– a type of electroneurography, allows you to study the speed of passage of electric current along a peripheral nerve with a parallel study of the reaction of the muscles that are innervated by this nerve.
In addition to those parameters that electroneurography reveals, ENMG reveals pain tolerance and the sensitivity threshold of possible trigger zones of the trigeminal nerve, as well as the degree of contraction of muscle fibers in response to increased excitation of the nerves.
Electroencephalography (EEG)
EEG– a method for diagnosing the nervous system, in which a special electroencephalograph apparatus records the biological electrical activity of the brain, depicting them in the form of curves. This method allows you to identify structures through which the passage of impulses is disrupted.
What is revealed by EEG during a paroxysmal attack of trigeminal neuralgia?
- changing curves in synchronized or unsynchronized type,
- signs of epileptic foci in the hindbrain and midbrain, in the locations of the trigeminal nerve nuclei.
Additional consultations with narrow specialists for trigeminal neuralgia
- ENT – it is necessary to identify and, if necessary, treat chronic diseases of the nasopharynx.
- Neurosurgeon - when identifying a pathology of the central nervous system, which could lead to the development of neuralgia, it is necessary to decide on the need for surgical treatment.
- Dentist - to carry out differential diagnosis of trigeminal neuralgia with dental diseases and, if necessary, sanitize the oral cavity.
Laboratory research methods
With trigeminal neuralgia, laboratory diagnostics are not very informative; usually the biochemical parameters of blood and other biological fluids are normal. At the moment, there are no specific laboratory indicators indicating neuralgia, in general, including trigeminal neuralgia.But while taking medications to treat neuralgia, it is necessary to monitor their tolerance. To do this, biochemical studies of the liver, general analysis of urine and blood are periodically carried out.
If there are symptoms of inflammation of the meningeal membranes (meningeal signs), it is necessary to perform a spinal puncture, followed by laboratory testing of the cerebrospinal fluid (CSF). This is necessary to exclude meningitis.
In case of herpetic lesions of the trigeminal nerve, it is necessary to monitor the level of immunoglobulins A, M, G to herpes types I, II, III.
Treatment of trigeminal neuralgia
Treatment of trigeminal neuralgia should be comprehensive:- elimination of the causes that provoked the development of trigeminal neuralgia.
- decreased excitability of the central nervous system;
- stimulation of restoration of the myelin sheath of the damaged trigeminal nerve - at the moment there are no means to completely restore myelin, scientists around the world are working on the development of such an effective drug, but some measures are used to stimulate the restoration of the myelin sheath;
- physiotherapeutic effects on the branches of the trigeminal nerve and trigger zones.
Drug treatment of trigeminal neuralgia
| Group of drugs | Preparation | Mechanism of action | How to use? |
| Anticonvulsants(selection of the drug and its dose is carried out individually) | Carbamazepine (finlepsin) | Effects of taking anticonvulsants:
Other effects: release of glutamate (a neurotransmitter that promotes inhibition of nerve impulses) and inhibition of the production of neurotransmitters that promote the excitation of nerve fibers (dopamine and norepinephrine). Attention! Anticonvulsants are psychotropic drugs and have many side effects, so they are sold in pharmacies only with a doctor's prescription. | The drug is administered gradually in small doses, then the dosage is increased. Treatment is started with 100-200 mg 2 times a day, then increased to 400 mg 2-3 times a day until pain attacks stop. Later, you can reduce the dose to maintain the therapeutic effect to 100-200 mg 2 times a day. The treatment is long-term. |
| Phenytoin (diphenin) | Start with a dose of 3-5 mg per kg per day, then increase the dose to 200-500 mg per day. The dose is taken once or divided into 2-3 doses, only after or during meals. The treatment is long-term. | ||
| Lamotrigine | The initial dose is 50 mg 1 time per day, then the dose is adjusted to 50 mg 2 times per day. The treatment is long-term. | ||
| Gabantine | The mechanism of action of this drug is not known; its high effectiveness in treating trigeminal neuralgia has been experimentally proven. | The initial dose is 300 mg per day, maximum 1800 mg per day. The drug is taken in 3 doses. | |
| Stazepin | Start with 200 mg per day, increase the dose to 600 mg per day. Take in 3 doses. | ||
| Muscle relaxants | Baclofen (baclosan, lioresal) | Baclofen is effective in treating neuralgia by stimulating the production of the neurotransmitter GABA (gamma-aminobutyric acid). Effects of using muscle relaxants:
| The initial dose is 15 mg in 3 doses, then gradually it is increased to 30-75 mg per day in 3 doses. |
| Mydocalm |
| The initial dose is 150 mg per day in 3 doses, the maximum dose is 450 mg per day in 3 doses. | |
| Vitamin preparations | B vitamins (neuromultivit, neurovitan and other complexes) |
| 1 tablet 3 times a day with meals. |
| Omega-3 unsaturated fatty acids (dietary supplement) | Unsaturated fatty acids are the material for the structure of myelin. | 1-2 capsules per day with meals. | |
| Antihistamines | Diphenhydramine, pipalfen | Strengthen the effect of anticonvulsants. | Diphenhydramine 1% 1 ml before going to bed at night, Pipalfen 2.5% - 2 ml before bedtime in the form of injections. |
| Sedative and antidepressant drugs | Glycised (glycine) | Glycine is an amino acid that is a neurotransmitter that inhibits the processes of excitation of the nervous system. It has a calming, anti-stress effect and normalizes sleep. | Dissolve 2 tablets 3 times a day under the tongue. |
| Aminazine | Aminazine blocks receptors that receive impulses from transmitting nerve fibers. Thanks to this, the drug has a calming effect and reduces psychotic reactions in acute and chronic psychoses. | 20-100 mg every 4-6 hours orally. Injection of the drug is necessary for acute psychotic reactions. 25-50 mg is administered once, and if necessary, the drug is re-administered. This drug is continued until the patient’s mental state normalizes. | |
| Amitriptyline | It has an antidepressant effect due to the regulation of the release of neurotransmitters. | Initial dose: 75 mg in 3 doses, then increase the dose to 200 mg in 3 doses. It is recommended to take the drug during meals. |
In case of severe trigeminal neuralgia, constant pain, it is recommended to prescribe even narcotic drugs (sodium hydroxybutyrate, cocaine, morphine, and so on).
Previously, blockades of the branches of the trigeminal nerve with 80% ethyl alcohol (alcoholization), glycerin and novocaine were widely used. However, at the moment, it has been proven that, despite the rapid analgesic effect, these procedures contribute to additional trauma and destruction of the myelin sheath of the trigeminal nerve, which in the future (after just six months) leads to the progression of the disease with short remissions and long-term attacks of pain.
Be sure to carry out correction of those conditions that may have led to the development of the disease:
- treatment of ENT pathology,
- therapy for cerebrovascular diseases,
- adequate sanitation of the oral cavity,
- antibacterial (or antiviral) and immunocorrective treatment of infectious diseases,
- prevention of connective tissue growths (scars) after injuries, surgical treatment and infectious processes; for this purpose, it is effective to prescribe biostimulants (aloe extracts, placenta, FiBS), short courses of small doses of glucocorticosteroids (hormones) and physiotherapy procedures,
- normalization of metabolism, in case of its disorders (diet, vitamin therapy, hormonal correction, and so on),
- other measures, depending on the causative diseases and conditions.
Surgical treatment for trigeminal neuralgia
Surgical treatment of trigeminal neuralgia is recommended if it can effectively solve the problem with minimal risks of postoperative complications. They also offer facilitating surgical procedures in the absence of clinical effect from the drug therapy (after 3 months of no positive results).- Prompt solution to problems that cause neuralgia:
- removal of brain tumors(the extent of the operation is determined by the type, location and extent of the tumor process),
- microvascular decompression– displacement or resection (removal) of dilated vessels that put pressure on the trigeminal nerve or its nuclei,
- widening of the narrowed infraorbital canal(the exit point of the trigeminal nerve) is a low-traumatic operation on the bones of the skull.
With the effective elimination of the causes that caused compression of the trigeminal nerve, attacks of trigeminal neuralgia often go away, and the outcome is recovery.
- Surgical intervention aimed at reducing the conductivity of the trigeminal nerve:
- Cyber Knife– modern effective treatment of trigeminal neuralgia. Moreover, unlike other traumatic operations, the risk of complications is minimal (on average 5%). Cyber Knife is a type of radiosurgery that does not require punctures, incisions or other traumatic manipulations. It can be carried out outside a hospital hospital (outpatient).
This method is based on the impact of a thin beam of radiation on the area of increased excitability of the nerve fibers of the trigeminal nerve or its nucleus. - Gamma Knife as well as Cyber Knife - a method of radiosurgery in which beams of radiation destroy the trigeminal ganglion. It also has a low risk of complications. Its effectiveness is inferior to Cyber Knife.
- Balloon compression of the trigeminal ganglion – A catheter is inserted through the skin into the area of the trigeminal nerve ganglion, through which a balloon is installed and filled with air. This balloon compresses the ganglion, over time destroying the branches of the trigeminal nerve, thereby eliminating the conduction of nerve impulses into the central nervous system. This method has a temporary effect and can lead to the development of complications (numbness of the face, distorted facial expressions, impaired chewing).
- Trigeminal ganglion resection- a complex traumatic operation that requires craniotomy, removal of the ganglion by excision with a scalpel and long postoperative recovery, and also has a high risk of complications.
- Other types of surgical operations aimed at removing the trigeminal ganglion or branches of the trigeminal nerve are traumatic and often cause complications.
- Cyber Knife– modern effective treatment of trigeminal neuralgia. Moreover, unlike other traumatic operations, the risk of complications is minimal (on average 5%). Cyber Knife is a type of radiosurgery that does not require punctures, incisions or other traumatic manipulations. It can be carried out outside a hospital hospital (outpatient).
- capabilities of the medical institution and surgeons,
- financial capabilities of the patient (radiosurgery methods are quite expensive),
- the presence of concomitant diseases,
- general condition of the patient,
- the reasons that led to the development of neuralgia,
- the presence of individual indications and contraindications for a certain type of surgery,
- patient's response to drug treatment,
- the risk of developing postoperative complications and so on.
Physiotherapy for trigeminal neuralgia
Physiotherapy– effective measures for relieving pain in trigeminal neuralgia. Depending on the degree of damage, the frequency of relapses, and the cause of neuralgia, one or another method of physical influence on the trigeminal nerve or its nuclei is prescribed. Physiotherapy methods
| Method | Effect | Principle of the method | Duration of treatment |
| Ultraviolet irradiation (UVR) of the face and neck | Relieving pain syndrome. | Ultraviolet irradiation (namely medium wave) promotes the release of neurotransmitters that inhibit the excitation of nerve fibers and natural analgesics. | 10 sessions |
| Laser therapy |
| The laser is applied to the localization areas of each branch of the trigeminal nerve, as well as the nodes formed by this nerve. Laser irradiation inhibits the sensitivity of nerve fibers. | On average, 10 procedures of 4 minutes are recommended. |
| UHF |
| Exposure to ultra-high frequencies promotes:
| 15-20 sessions of 15 minutes each |
| Electrophoresis |
| Electrophoresis is the introduction of medicinal substances using an electric current directly into the desired area of the nerves. To relieve pain the following is administered:
Also, using electrophoresis, you can introduce B vitamins, which will improve the nutrition of the nerve and damaged myelin sheath. | It is better to alternate these procedures with other methods of physiotherapy every other day, for a total of 10 procedures. |
| Diadynamic currents |
| For this method, Bernard currents are used, which are electric currents with a pulse of 50 thousand hertz. Electrodes are placed on the area of trigger zones of the trigeminal nerve, including the nasal mucosa. Bernard current reduces the threshold of pain sensitivity, blocks the branches of the trigeminal nerve, thereby reducing the intensity of the pain syndrome until it stops completely. The use of diadynamic currents in combination with electrophoresis and other methods of physiotherapy is effective. | Several courses of 5 days with a break of 5-7 days, the procedure lasts for 1 minute. |
| Massage | Prevention and treatment of atrophy of facial and masticatory muscles. | Massaging the muscles of the face, head and neck improves blood circulation and lymph flow, thereby improving their nutrition. The massage is carried out carefully; it should not affect trigger zones and provoke the development of pain attacks. Use movements of stroking, rubbing, and vibration. A course of massage is prescribed only against the background of stable remission of the disease. | 10 sessions. |
| Acupuncture (acupuncture) | Relieving pain syndrome. | Acupuncture affects nerve receptors that transmit impulses to nerve fibers. In this case, several points are selected in the trigger zones and several points remotely on the opposite side. Sometimes the needles are installed for a long period - a day or more, periodically scrolling them. | The duration of treatment is selected individually; often only a few procedures are enough.  |
All physiotherapeutic methods of treatment should be used in combination with drug therapy and the elimination of factors that led to the development of the disease, since physical procedures are powerless as monotherapy (mono-one).
Prevention of trigeminal neuralgia
- Timely seeking medical help for the treatment of acute and chronic diseases of the ENT organs, timely sanitation of the oral cavity, and so on.
- Annual preventive medical examinations in order to identify diseases of internal organs, endocrine glands, nervous and cardiovascular pathologies.
- Avoid injury to the face and head.
- Avoid drafts and other types of hypothermia.
- Control of blood pressure and treatment of hypertension, vegetative-vascular dystonia, atherosclerosis and other vascular diseases.
- Healthy lifestyle:
- full physical activity,
- proper sleep and rest,
- adequate response to stressful situations,
- proper healthy diet containing sufficient amounts of vitamins, microelements, unsaturated fatty acids and amino acids.
- hardening,
- quitting smoking, drug and alcohol abuse, etc.
- You cannot self-medicate pain in the facial area, remember that any manipulation can aggravate the course of trigeminal neuralgia.
Be healthy!
All the causes of neuralgia come down to one thing: under the influence of any circumstances, the nerve becomes damaged and ceases to fully perform its functions.
The factors that provoke such damage are most often:
- inflammatory or infectious processes in the teeth and gums or paranasal sinuses;
- injuries of soft and bone tissues of the face and head;
- acute and chronic infections (herpes, flu, etc.);
- hypothermia;
- neoplasms in the region of the trigeminal nerve.
Often, inflammation of the trigeminal nerve becomes a complication of sinusitis, pulpitis, otitis and other diseases of the ENT organs and oral cavity, which were treated using home methods. Neuralgia can also occur a short time after treatment or tooth extraction. In the latter case, the cause is medical errors, non-compliance with the dentist’s recommendations for the recovery period, and infections that were not identified before dental intervention.
Symptoms of trigeminal neuralgia
Symptoms of trigeminal neuralgia can vary depending on which branch of the nerve is affected. But the following manifestations of the disease are typical for most cases:
- Severe pain in the face. It usually affects only one side of the face—the side on which the affected nerve is located.
- A sharp increase in pain when the skin comes into contact with cold or very warm air, when chewing food or talking.
- Noticeable redness of the skin on the side of the inflamed nerve.
- Sensitivity disorders of the skin and soft tissues on the inflamed side - both increased and decreased sensitivity may be observed.
- Spontaneous contractions of masticatory and/or facial muscles.
- Increased salivation and lacrimation.
The pain of trigeminal neuralgia is often described as a “shooting” pain, similar to an electric shock. It can last for several seconds and disappear on its own until the next attack is provoked by cold, heat, chewing loads, etc. In other cases, the pain practically does not recede and literally deprives a person of peace and sleep.
