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NATIONAL CENTER FOR NEUROSURGERY

Neuralgia of the cranial nerves

To the cranial nerves refer the trigeminal, glossopharyngeal, and facial nerves.

Trigeminal neuralgia (hereafter TN)

The trigeminal nerve is the main nerve providing sensitivity of the face - surface sensitivity - pain and tactile,and deep sensitivity - proprioceptive. TN is increasingly common in women between 50-69 years old and has a right-sided laterality. To the development of the disease contribute various vascular diseases, endocrine-metabolic, allergic disorders, and psychogenic factors. It is believed that TN is an idiopathic disease. However, there are several theories explaining the pathogenesis of the disease. The most likely cause of the TN is the compression of the trigeminal nerve inside or outside the skull. The causes of compression may be a tumor, adhesions after injury, infections, but most of all - deployment and expansion of the convoluted cerebellar arteriesand veins. As a possible cause is an aneurysm of the basilar artery.

Among the extracranial factors are observed:

  1.  formingof tunnel syndrome (compression of the 2nd and 3rdbranches in bone channels - infraorbital foramen and mandibulum at their congenital narrowness and vascular diseaseslate in life),
  2.  as a result of local odontoorrhinogenous inflammatory process.

The disease can develop after a tooth extraction (alveolar nerve is affected) - odontogenic neuralgia due to impaired circulation in the brain stem, resulting in herpes infection, rarely due to trigeminal nerve demyelination in multiple sclerosis.

Symptoms

  •  pain in the face comes suddenly, attack lasts up to several seconds
  •  pain can be severe, shooting and remind electric shock
  •  pain may suddenly appear after touching the face, during chewing, speaking or brushing teeth
  •  pain extends to the areas of the face innervated by the trigeminal nerve - the lower jaw, cheek, gums, lips, sometimes eyes or forehead
  •  pain is accompanied by autonomic responses - lacrimation, hypersalivation (uncontrolled drooling), erythema (redness).
  •  in damage to the mandibular branch of the trigeminal nerve are possible motor dysfunction in the masticatory muscles - twitching, spasms, atrophy.

Neuralgia of the glossopharyngeal nerve

Neuralgia of the glossopharyngeal nerve is quite rare - the attack begins in pains in the throat and extends to the ear and jaw. In this disease, there also exist trigger points - in the back of the mouth, in the area of the tongue root , tonsils.

Methods of treatment

  •  Radiofrequency thermal decomposition
  •  Microvasculardecompression