Neuralgia is caused by irritation or nerve damage from systemic disease, inflammation, infection, and compression or physical irritation of a nerve. Some of the causes of cranial nerve lesions are given below, after a reminder of the anatomical course of the nerve. The trigeminal nerve plays a very important role in the face, being responsible for sensing touch, pressure, pain and temperature in the jaw, gums, forehead and around the sensitive eye area. A GP with a list size of 2,000 will see four to six cases per year. Ocular examination revealed normal ocular movements in both eyes. Diseases that cause nerve inflammation can also damage the myelin sheath. There was no history of transient ischemic attack, convulsion, dimness of vision, or herpes zoster.
The “atypical” form of the disorder known as TN2, is characterized by constant aching, burning, stabbing pain of somewhat lower intensity than TN1. Tic doloureux occurs almost exclusively in people over 60. Typically decades later, when a person who had chickenpox has some dip in immune resistance, the virus travels along a sensory nerve to the skin, where it can replicate and cause painful, burning rashes and blisters. Moreover, the endoscopy (during microvascular decompression) and the intraoperative computed tomography with integrated neuronavigation (during percutaneous procedures) have been recently introduced in the challenging cases. Men can get attacks when they shave, while women can get them while applying facial powders or creams. The episodes of pain occur suddenly, sometimes triggered by common activities or cold exposure, and are said to feel like stabbing electric shocks. Trigeminal neuralgia: A guide to drug choice.
CNS Drugs 7: 2 (FEB 1997):98-110. Carbamazepine is the drug of choice, and treatment requires careful dosage titration. Doesn’t work 100% but it definitely helps take the edge off. In some cases, compression neuralgia (including occipital neuralgia) can be relieved by surgery. clonazepam is too sedating, pimozide induces extrapyramidal adverse effects, and tocainide and felbamate can cause aplastic anaemia. For this case study I would like to recommend a supplement which contains the B complex of vitamins (B6 is in the form of pyridoxine-5-phosphate 25mg ).