Trigeminal Nerve - Causes And Symptoms Of Neuritis (inflammation) Of The Trigeminal Nerve

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Neuritis (inflammation) of the trigeminal nerve

What is trigeminal neuritis?

Of the twelve pairs of cranial nerves, the trigeminal nerve is the fifth in a row. The main function of the trigeminal nerve is to provide sensitivity in the facial area. The trigeminal nerves are located on opposite sides, one on the left, the other on the right. Three branches extend from the trigeminal nerve. One branch gives sensitivity to the eye, upper eyelid and forehead. The second branch provides sensitivity to the lower eyelid, cheek, nostrils, upper lip and upper gum. The third branch is used to implement the sensitivity of the lower jaw, lower lip, gums and some masticatory muscles.

The pain caused by trigeminal neuralgia is perhaps one of the most excruciating pains that a person experiences. Typically, the pain is localized to the lower face and jaw, but it happens that the pain affects the area around the nose and above the eyes. The pain that occurs with trigeminal neuralgia is so strong that it can be compared to an electric shock. Such severe pain occurs due to irritation of the trigeminal nerve, from which branches go to the forehead, cheeks and lower jaw. The pain usually occurs in one side of the face.

Unfortunately, it is not always possible to completely cure trigeminal neuralgia. However, there are still ways that help to significantly reduce pain in this disease. Anticonvulsants are used primarily. In cases where medication treatment does not bring relief or serious side effects occur, surgical methods of treatment are used.

Causes of trigeminal neuritis

Trigeminal neuralgia is accompanied by severe pain, as the trigeminal nerve is irritated. As a rule, the cause is the contact of an artery and vein with the trigeminal nerve near the base of the skull. The nerve is compressed, and this gives severe pain. Other possible causes of trigeminal neuralgia include tumors that compress the nerve, multiple sclerosis, which leads to the destruction of the myelin sheath of the nerve. In young people, the development of trigeminal neuralgia is usually associated with multiple sclerosis.

Despite the fact that the etiology of the disease is very wide, but, fortunately, it is not realized in all cases.

The main reasons for the development of trigeminal neuritis are:

1. Postponed viral infection. Almost any virus can cause neuritis. But representatives from the herpes family are considered the most important causative agent. In the first place among them is shingles;
2. Immune dysfunction of the body. Against this background, herpes viruses are able to become more active than in a healthy body;
3. Hypothermia of local and general nature. Most often, trigeminal neuritis occurs after being in a draft or other exposure to low temperatures on one of the halves of the ear and facial areas;
4. Strong physical stress and psycho-emotional shock, which lead to the depletion of the body's defenses;
5. Poor nutrition, and as a result, immune dysfunction;
6. Severe infections of any localization, if they are long-term and require aggressive treatment.

The reasons contributing to the onset of an attack of trigeminal neuralgia include:

• touching the skin of the face;
• washing;
• shaving;
• teeth cleaning;
• blow to the nose;
• light breath of wind;
• makeup;
• smile;
• conversation.

Symptoms of trigeminal neuritis

For some people, pain occurs unexpectedly for no apparent reason. Other patients, in addition to pain, note other symptoms of trigeminal neuralgia, for example, pain occurs after a stressful situation, such as a car accident, a blow to the face, or a visit to the dentist. However, doctors, including dentists, believe that, most likely, the pathology developed much earlier, and the stressful situation only served as an impetus for the onset of pain. Since pain usually begins in the area of the upper or lower jaw, a person mistakenly assumes that the pain is associated with the teeth. The person seeks a doctor for dental treatment, but this does not relieve the pain.

The clinical picture of the disease is quite vivid and consists of the following sudden symptoms:

1. Severe shooting, piercing pain in the region of one of the halves of the face, which is of a through nature;
2. Skewness of one of the halves or individual parts of the face, and the associated distorted facial expressions (the corner of the mouth, eyes, eyelids are lowered);
3. Periodic twitching of the muscles in the innervation area of the affected nerve;
4. General hyperthermic reaction of the type of moderate increase in body temperature;
5. General weakness, chills, muscle pain throughout the body;
6. Fatigue and irritability due to insomnia due to severe pain syndrome;
7. Headaches;
8. Small rash in the area of the affected part of the face.

The most central manifestations of trigeminal neuritis are insanely severe pain in one of the halves of the face, which simply exhausts patients with the suddenness of their shots from the ear region to the midline of the head. After its reduction, a distortion of facial expression is added, which causes a gross cosmetic defect. If the disease acquires a protracted or progressive course, the described changes may remain for life.

Symptoms accompanying trigeminal neuralgia can occur with other diseases. This can be tendinitis, Ernest's syndrome, and occipital neuralgia.

Temporal tendonitis is accompanied by pain in the cheek and teeth, and the patient is also worried about headache and pain in the neck. When the stylo-mandibular ligament is damaged, which connects the base of the skull to the lower jaw, the so-called Ernest syndrome develops. This syndrome is also accompanied by headaches and pain in the neck and face. Occipital neuralgia is accompanied by pain in the back of the head, sometimes extending to the face.

Pain with trigeminal neuralgia can be divided into typical and atypical.

Typical pain is characteristic of trigeminal neuralgia; during the course of the disease, it occurs and then subsides. The pain is usually shooting, resembling an electric shock, as a rule, after touching certain parts of the face.

Atypical pain is usually constant and affects most of the face. During the course of the disease, there are no periods of abatement of pain. Such neuralgia is much more difficult to treat. Trigeminal neuralgia is referred to as cyclical diseases, since periods of exacerbation are replaced by periods of decay. The pain usually lasts for a while, with small gaps in between. In other patients, pain occurs only once a day. It happens that a person is tormented by pain every hour. The pain begins very abruptly, reaches a maximum in 20 seconds, after which it continues for a certain time.

Treatment

The earlier neuritis is recognized and treatment is started, the higher its effectiveness will be.

It should start almost from the first day of the disease and includes a set of measures:

1. Antiviral drugs. Indicated in the case of neuritis caused by the herpes virus. The gold standard is acyclovir and its analogues (herpevir, lavomax);
2. Pain relievers. In connection with a pronounced pain syndrome, not only non-narcotic analgesics (ketanov, dexalgin, ketalgin) are shown, but also narcotic drugs (promedol, tramadol, morphine, nalbuphine):
3. Non-steroidal anti-inflammatory drugs: dicloberl, indomethacin, rheumoxib, movalis, celebrex;
4. Glucocorticoids. They reduce inflammation and swelling of the nerve, having a good effect in a short time. These include methylprednisolone, dexamethasone, hydrocortisone;
5. Drugs that reduce muscle spasm: midocalm, sirdalud;
6. Vitamins and neuroprotectors: milgama, thiogama, neuroubin, neurobion, proserin.
7. Physiotherapy treatment: UHF, electrophoresis, paraffin-ozokerite, magnetotherapy.

Facial massage for nerve neuritis

The main task of massage for trigeminal neuritis is to relieve increased muscle tension in certain muscle groups and increase tone in those muscle groups that are atonic. This improves microcirculation and blood supply not only in the affected surface tissues, but also directly in the inflamed nerve. In terms of massage, the first place is the impact on the reflex zones in the places where the branches of the trigeminal nerve exit in the face, ear and neck. After that, you need to work with the skin and muscles.

The massage is performed in a sitting position, with the head reclined against the headrest so that the neck muscles relax. They start with them with light massaging movements. Attention is focused on the sternocleidomastoid muscle. After that, they rise up to the parotid areas with rubbing and stroking movements. Then the face is massaged, first the healthy side, and then the affected one. The duration of the procedure is about 15 minutes. The number of sessions per course of treatment is 10-14.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".