neuralgi

Neuralgia is a pain condition characterized by sharp, intense episodes along the distribution of a nerve. It is a symptom category rather than a single disease, and several conditions fall under neuralgia, the best known being trigeminal neuralgia and postherpetic neuralgia. Other forms include occipital neuralgia and glossopharyngeal neuralgia.

Causes of neuralgia include nerve compression or irritation (for example, vascular compression of the trigeminal nerve), nerve injury or inflammation, demyelinating diseases such as multiple sclerosis, infections such as herpes zoster, metabolic disorders like diabetes, and, in some cases, idiopathic origins. The resulting pain is typically brief and severe, though some conditions may feature ongoing discomfort between episodes.

Symptoms commonly involve sudden, stabbing or electric shock-like pains in the affected nerve’s area. The pain may be unilateral and triggered by light touch, chewing, speaking, temperature changes, or other stimuli. Some neuralgias also produce constant aching or burning between sharp episodes.

Diagnosis is based on clinical history and neurologic examination. Imaging, especially MRI, can help identify structural causes or vascular compression. Tests may be used to rule out other conditions, and nerve blocks can aid in diagnosing certain focal neuralgias.

Treatment aims to control pain and address underlying causes. First-line medications often include anticonvulsants such as carbamazepine or oxcarbazepine, and certain antidepressants (e.g., amitriptyline, nortriptyline) for neuropathic pain. Gabapentinoids or topical lidocaine patches may be used as well. For refractory cases, procedures such as nerve blocks, radiofrequency ablation, gamma knife radiosurgery, or microvascular decompression may be considered. Vaccination and antiviral therapy are relevant for postherpetic neuralgia prevention and management. Prognosis varies; many patients achieve meaningful relief with appropriate therapy, though chronic pain can persist in some cases.