Neuralgia

Specialty of Neurology

What is neuralgia?

Neuralgia refers to a severe pain which occurs due to an irritated or damaged nerve. This condition is more common in the elderly but it can affect anyone at any age. Types of neuralgia include:

  • Post-herpetic neuralgia: occurs as a complication of shingles, resulting in ongoing pain after a herpes zoster outbreak.
  • Trigeminal neuralgia: affects the trigeminal nerve, causing severe, re-occurring pain in part of the face.
  • Glossopharyngeal neuralgia: affects the glossopharyngeal nerve, but is less common than other types, producing pain in the neck and in the throat.

What are the symptoms of neuralgia?

The symptoms of neuralgia usually include:

  • Acute pain: this is the main symptom of neuralgia and presents as a very intense pain felt throughout the area of ​​the affected nerve.
  • More sensitive skin in the region of the nerve that leads to intense pain with contact.
  • Muscle weakness where the nerve is located. Sometimes the muscles also become temporarily paralysed.

What are the causes of neuralgia?

In many cases the causes of neuralgia is unknown, but it can be due to some of the following factors:

  • Chronic kidney disease.
  • Consumption of certain medications.
  • Infectious diseases such as herpes zoster virus, HIV or syphilis.
  • Pressure in the nerve by some bone, blood vessel or tumour.
  • Trauma
  • Diabetes
  • Porphyria

Neuralgia can also be caused by an infection affecting the nerves, or result through nerve damage/injury to a nerve. However, the cause of particular types of nerve pain is not completely understood.

Can neuralgia be prevented?

One way to prevent neuralgia is to control blood glucose in patients with diabetes. Vaccines and antiviral drugs against the herpes zoster virus can also prevent neuralgia.

Treatment of neuralgia

The treatment for neuralgia will depend on the causes, the location of the nerve and the degree of pain. Pharmacological treatment for pain includes antidepressants, anticonvulsants, analgesics and patches or relaxing creams.

Other treatments that can be carried out are:

  • Physiotherapy, especially in postherpetic neuralgia.
  • Injections of medication to relieve pain.
  • Treatments to relieve pain such as radiofrequency, heat application, chemical injection or balloon compression.
  • Blockage of the nerves.
  • Surgical intervention to relieve pain.
  • Stimulation of the nerves or the spinal cord, especially when other treatments fail to relieve the symptoms of neuralgia. In some cases stimulation of the motor cortex is performed which involves placing an electrode in the nerve, brain or spinal cord to connect it to a pulse generator.
  • Some may find therapeutic treatments such as acupuncture help, but it is important to consult your doctor about any complementary therapies you are considering

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