Occipital neuralgia is a pain syndrome which may usually be induced by spasms of the cervical muscles or trauma to the greater or lesser occipital nerves. The initial cause of the neuralgia appears to be from inflammation, damage or irritation of these nerves. It is more common and is more problematic to treat in older people. Often, no physical cause can be found, although some forms of neuralgia may be triggered when nerves are compressed by injuries, arteries, tumors, or, in rare cases, as the result of nerve damage from multiple sclerosis. Neuralgia is an uncommon condition, with trigeminal neuralgia occuring most often. Microvascular compression is an accepted cause of classic TNG but little is known about the etiology of idiopathic ON and NIN, apart from two articles suggestive of microvascular compression. The cause is not known.
Most neuralgias appear suddenly, with no apparent physical basis for the pain, which can be severe. It is caused by reactivation of the Varicella-zoster virus that enters the body following a chickenpox infection that may have occurred years ago. Preferred using 5% lidocaine but found elderly more likely to get dizzy from injections I found using 5%, unlikely to have problems if stick to 2 mls for usual adults, and under 1-1.5 for elderly. This small amount of concentrated PRP is then injected into the joint or other body area, that needs regeneration, after local anesthetic is administered. The head pain can be anywhere from a nagging aching pain to an excruciating migraine headache type of pain, which can be debilitating. It is rare to occur on both sides of the face. The cause of Headaches varies depending on its source, it may arise from the network of nerve fibers in the tissues, muscles, and blood vessels located in the head and at the base of the skull.
Headaches can be caused by either a primary (within the head) or secondary source. The pain associated with TN is recognized as one of the most excruciating pains that can be experienced. Patients with migraines have a higher probability than the general population of demonstrating nonenhancing white matter lesions on magnetic resonance imaging (MRI). Occipital neuralgia is caused by pain from one of the two occipital nerves that supply the back of the head. Some patients experience muscle spasm, which led to the original term for TN of “Tic douloureau”, meaning painful, in French). Although most neuralgias have no known cause, one type, postherpetic neuralgia (PHN) is only seen following an outbreak of shingles, a painful, blistering rash caused by the Herpes zoster virus, the same virus that causes chicken pox. Nonprescription and prescription pain medicines sometimes work well for neuropathic pain.
Older people, especially those with weak immune systems, can suffer a relapse, with the rash appearing along the course of the nerve that is affected. It starts to work only after four days of application. PHN and TN are the most common types of neuralgia. The patient has attacks of pain in the face that last less than two minutes. So, it is INTENSE pain that is just anterior of center, to the left side maybe 1-1/2 inches. Trigeminal neuralgia may be numbed with radio frequency waves, gamma rays or glycerol injections if the patient does not respond to drug treatment. Pressure – compression of the nerve by surrounding structures in the body.
Lumbar neuralgia gives rise to pain in the lumbar region, along the crest of the ilium, in the inguinal and femoral regions, and in the spermatic cord, scrotum, or vulva. In many patients, TN can be positively diagnosed if the drug carbamazepine (Tegretol) diminishes the pain of an attack. It is a constant and severe nerve pain. Great site! Occipital neuralgia is caused by pain from one of the two occipital nerves that supply the back of the head. Sedation is often given at the time of injections to promote relaxation and comfort. X rays and CT scans can help indicate if the nerve is compressed; numbing the nerve with anesthetics can pinpoint the cause.
Trigeminal neuralgia was identified almost 2,000 years ago. Capsaicin cream does work better than placebo creams, but the relief is not total. The patient was satisfied with the reduction in pain but commented on difficulty of possibility in its recurrence after 3 months when medical treatment and botox injection treatment done in 3 to 4 week intervals are executed. These include baclofen and amitryptyline (see following). A whole foods diet with adequate protein, carbohydrates, and fats that also includes yeast, liver, wheat germ, and foods that are high in B vitamins is important. Essential fatty acids, such as flax or fish oil, may also help reduce inflammation. Homeopathic treatment can also be tried.
There is no consensus on IHP treatment, but the most common approach is to initiate corticotherapy and then to add immunosuppressants. The pain of neuralgia may also be relieved by hydrotherapy (hot shower or bath), deep massage, reflexology (massaging reflex points in the feet relating affected painful areas in the body) or yoga exercises. In addition, guided imagery, biofeedback therapy, and hypnosis may be beneficial. Patients should also consider t’ai chi, qigong, and other movement therapy. Patients may also be helped by transcutaneous electrical nerve stimulation (TENS), in which a weak electrical current applied to the skin interferes with the nerve’s ability to send pain signals to the brain. Although somewhat controversial, initial results, especially for postherpetic neuralgia, are promising. Once a diagnosis of neuralgia has been established, physicians prescribe drugs to alleviate the pain.
The anti-convulsant drug carbamazepine (Tegretol) is often an effective treatment for TN, relieving or reducing the pain within a day or two. Unfortunately, it can also cause dizziness, drowsiness, nausea, and double vision, as well as other side effects. If Tegretol is not well tolerated, doctors can try another anitconvulsant, like gabapentin (Neurontin), antispasmodics like baclofen (Lioresal), or anti-anxiety drugs like clonazepam (Klonopin). These drugs are also frequently prescribed for other forms of neuralgia as well. Injecting local anesthetics into the nerve can stop the pain for a few hours, and for some patients this is effective for a much longer time. Lidocaine cream may be somewhat helpful in treating PHN, probably by temporarily desensitizing nerves just under the skin. Medications such sumatriptan (Imitrex) are used to treat it.
Pain is often worse when lying down. One particularly unpleasant, but evidently successful, method of treating neuralgia seems to be desensitization. This means that if a patient is bothered by the touch of clothing on the skin, the therapist may rub a towel briskly over the area for a few minutes. If the patient has trouble tolerating heat or cold, warm or cold water may be applied. De Moragas JM, Kierland RR. For PHN, the best treatment seems to be prevention. People with shingles should see a doctor as soon as the rash develops so they can receive treatment to ease the severity of the outbreak and minimize the risk of developing postherpetic neuralgia.
It is not clear, however, whether treatment can prevent subsequent neuralgia. A TN sufferer will sometimes seek the help of numerous clinicians before a firm diagnosis is made. It’s important to stress, though, that early attention to either a shingles outbreak or PHN episode will reduce the incidence and severity of future attacks. Some patients receive complete pain relief after treatment. Others are able only to reduce the pain (to greater or lesser degrees), while for a very few treatment is completely ineffective. Although superoxide is biologically quite toxic and is deployed by the immune system to kill invading microorganisms by utilizing the enzyme NADPH oxidase. In 2002, clinical trials showed that gabapentin (Neurontin) was effective in treating patients with PHN with relatively low adverse effects.
paroxysmal pain after brachial plexus avulsion. Most procedures try to reduce the nerve’s ability to send pain signals to the brain. One of the most promising is dorsal root entry zone (DREZ) lesioning, which uses radio frequency to disrupt the nerves that are causing pain. Some studies showed that as many as 80% of DREZ patients were helped. According to Acar et al (2008), C2 or C3 ganglionectomies are associated with short term pain relief (less than 3 months). PHN, in particular, tends to fade away on its own, and only 2–3% of patients have pain that lasts a year or longer. For those unfortunate few, however, PHN can become a lifelong, debilitating condition.