Neuralgia

Neuralgia is a severe, stabbing, or burning pain that is felt along the course of one or more nerves, but it is not caused by irritation of pain receptors, rather by damage or irritation of the nerve itself.

This pain is often acute, sudden, and may become chronic. Unlike ordinary pain, neuralgia occurs without a clear stimulus or in response to irritants that would not normally cause pain (such as a light touch).

Causes and Types

The causes of nerve damage leading to neuralgia can be varied:

• Infections: For example, herpes zoster (post-herpetic neuralgia), which damages nerve fibers.
• Trauma or pressure: Direct nerve damage or compression from surrounding structures (tumors, blood vessels, or bone changes).
• Systemic diseases: Diabetes (diabetic neuropathy), multiple sclerosis.
• Toxins or medications.

One of the most common and intense types is Trigeminal neuralgia, which affects the facial nerve (the fifth cranial nerve) and causes short, intense bouts of pain, often triggered by talking, chewing, or even a cold breeze.

Symptoms and Progression

The primary symptom is paroxysmal (sudden and episodic), sharp, acute pain along the course of the affected nerve. The pain can be described as an electric shock, stabbing, or burning sensation. It may be spontaneous or triggered by a light touch to a specific “trigger zone.” Between episodes, there may be pain-free periods. Over time, neuralgia may lead to restricted movements, muscle weakness in the affected area, or changes in sensitivity.

Diagnosis and Treatment

The diagnosis is primarily made through a thorough medical history and neurological examination, assessing the distribution of the pain. To identify the cause, imaging studies such as MRI or CT scans and blood tests may be used to rule out underlying conditions (e.g., diabetes).

Treatment focuses on alleviating the pain and, if possible, addressing the underlying cause:

• Medication: Specific drugs are used to stabilize nerve membranes, such as anticonvulsants (e.g., Carbamazepine) or certain antidepressants, which help control chronic nerve pain. Ordinary painkillers are often ineffective.
• Local procedures: Nerve blocks or corticosteroid injections.
• Surgical treatment: Applied in certain cases, such as trigeminal neuralgia, when the pain is caused by compression of the nerve by a blood vessel. Microvascular decompression is performed to release the nerve.

Synonyms: Nerve pain, Neuropathic pain, Neuritis, Sciatica.