Triple nerve. Examination by a doctor. Oriental medicine approach to treatment

There are 12 pairs of nerves in the human skull. Among them are the trigeminal nerves (left and right). These nerves are responsible for facial sensitivity. The trigeminal nerve is divided into three branches, each responsible for its own area on the human face. It is important to know the symptoms of inflammation trigeminal nerve to quickly begin treatment at home.

Symptoms of the disease

Inflammation of the trigeminal nerve of the face unpleasant disease. It exhausts a person, significantly worsens the quality of life, and causes a lot of unpleasant sensations. Pain can occur when brushing teeth, chewing, laughing, or talking. Painful sensations occur when the climate changes.

Manifests itself in the following symptoms:

• severe, persistent pain. Most often, pain lasts 3-4 minutes, then weakens;
• pulsating contractions of some facial muscles;
• spasms of the masticatory muscles;
• increased salivation.

Important! People often confuse neuralgia and toothache, therefore they do not give desired value illnesses, try to solve the problem on their own. This is dangerous both for nerve inflammation and for toothache of various origins.

Causes of inflammation of the trigeminal facial nerve

Among the reasons of this disease The following factors are highlighted:

1. Transmission of infectious diseases. This includes diseases such as tonsillitis, syphilis, tuberculosis and others.
2. Inflammatory processes in the area of ​​the maxillary sinuses, eye infections. Diseases oral cavity, teeth and gums.
3. Facial trauma can cause neuralgia.
4. Hypothermia of the body.
5. Weakened immunity.
6. Nervous disorders.

These are just some of the reasons that often cannot be established the real reason diseases.

Signs of neuralgia

The disease manifests itself quite sharply and has the following visible signs:

• the pain is sharp, localized, most often, on one side, of a paroxysmal nature;
• the face takes on an asymmetrical appearance, facial swelling appears. The corners of the eyes and lips may be distorted (drooped);
• the temperature during inflammation of the trigeminal nerve may be slightly elevated;
• loss of strength, irritability, insomnia, headache;
• manifestations often occur in the form of a rash on the affected side of the face;
• Inflammation of the trigeminal nerve often occurs after tooth extraction. This complication develops when the alveolar nerve is damaged.

A person with this disease is quite easy to recognize. It is in this case that we can say “the disease is obvious.”

Pain due to inflammation of the trigeminal nerve is quite severe and painful. Children suffer especially hard from the disease. Unfortunately, the disease often occurs in children. This is explained by the fact that children are often injured, suffer from hypothermia, and suffer from colds and other diseases.

Parents often ask the question: is it possible to heat the trigeminal nerve during inflammation? Doctors categorically prohibit heating neuralgia. Although a warm heating pad or compress may provide relief, it should not be used. When heated, the inflammation worsens and can spread to neighboring areas of the face. The first thing to do when symptoms of inflammation appear is to seek qualified help.

Important! Don't try to treat this serious illness, like trigeminal neuralgia in children. This is extremely dangerous and can lead to irreversible consequences.

In pregnant women

During pregnancy, a woman’s body is very unstable to various diseases. The immune system is weakened, as the body’s forces are concentrated on the formation and growth of the fetus. Neuralgia in pregnant women has its own characteristics. Let's try to figure it out in more detail.

The difficulty of treating inflammation of the trigeminal nerve during pregnancy is that most drugs aimed at treatment are unsafe for women carrying a child. For example, Carbamazepine provokes a decrease in the body folic acid, which is extremely undesirable for the mother and unborn child. This is especially dangerous in the first three months of pregnancy. During this period, treatment is limited to taking vitamins and general strengthening the body by correcting lifestyle and nutrition. In the subsequent months of pregnancy, drug treatment is less dangerous. The most common causes of neuralgia are:

• hormonal disorders;
• stress;
• unstable psychological condition pregnant;
• various viral diseases;
• facial injuries, dental diseases.

Despite all the complexity, in most cases it is possible to avoid complications and serious consequences.

Diagnostic methods

Among the examination methods, the main one is examination by a doctor. The neurologist examines the patient's face by palpation. The patient is asked to tell how long the pain has lasted, what its nature is, in what area it is localized, what could be the cause (cold, injury, stress, etc.). Often the patient is referred for ultrasound and MRI. During the examination, the patient may also be referred to an endocrinologist, immunologist, or allergist. This helps to make a more accurate diagnosis. After the doctor’s conclusion, a treatment regimen is prescribed.

Treatment at home

If the disease is not acute, the specialist prescribes to the patient drug treatment. The most commonly prescribed drug is carbamazepine. This drug has proven itself well in the fight against inflammation of this type. The patient can undergo treatment at home, according to the strict recommendations of the doctor. After a course of medication, even if the patient feels significant improvements, you should definitely make another appointment with a neurologist. Not in all cases, the absence of symptoms indicates a complete cure.

Important! Treatment at home should only be done in cases where the doctor has approved it.

Facial massage is effective for this disease. It can be done at home in front of a mirror. To do this, wash your hands and stand in front of a mirror. Start massaging your forehead and eyebrows with light movements. Under no circumstances should the pressure be aggressive. Go down to the area of ​​the nose, lips, and move along the cheeks with sliding movements. Such procedures help relieve nervous tension and pain.

Treatment with medications

Let's try to figure out what the most basic drugs are used in medical practice for the treatment of trigeminal neuralgia. Let's divide medications into groups:

Anticonvulsants. These are remedies aimed at relieving cramps and spasms. In first place among such drugs is carbamazepine. The treatment regimen with this drug consists of gradually increasing the doses of the drug until the pain decreases as much as possible, after which the dose of carbamesipine is reduced.

Very important! Take the drug strictly as prescribed by your doctor. Do not exceed the norm, as the drug can lead to severe toxic poisoning of the kidneys and liver.

Phenytoin and Convulex are often prescribed together with carbamesipine.

Drugs that relax muscles. These medications work well in combination with anticonvulsants.

1. Baclofen, sodium hydroxybutyrate, is often prescribed.
2. Finlepsin tablets have proven themselves well. Most often, 1-2 tablets are prescribed once a day, gradually increasing the dose to 3-6 tablets.

Antidepressants. A group of these drugs is used to relieve nervous tension and stress caused by pain during the disease process. This includes the drug amitriptyline and others.

1. For vascular diseases, trental and agapurine are used.
2. To remove local pain symptoms use diclofenac, lidocaine and other anesthetic ointments.
3. If the doctor suspects inflammation under the influence of viral disease, ceftriaxone and other antibiotics may be prescribed.

When especially severe cases diseases shown surgical intervention. The surgeon's actions are aimed at liberation nerve ending from vascular pressure. Such operations are performed in cases of ineffectiveness of drug treatment.

Treatment with folk remedies

Among traditional methods The following tips are common:

• Drink 1-2 glasses of chamomile tea daily. Chamomile has an anti-inflammatory, calming effect;
• Apply fir oil to a cotton swab or disk, rub into sore spot at least 5 times a day;
• a decoction of marshmallow root herbs, chamomile and mint. Pour the herbs in equal proportions (1 tablespoon each) into a liter of boiling water. Leave for 2-3 hours, strain, take half a glass 2-3 times a day;
• Black radish juice is used to relieve pain. To do this, squeeze out the juice, moisten a bandage or cotton wool and apply to the sore spot;
• using garlic oil. The oil is sold at the pharmacy. A drop of oil is diluted in 50 grams of vodka, the resulting mixture is wiped on the forehead and temporal areas;
• Brew willow bark with a liter of boiling water, simmer over low heat for 30 minutes. Let stand for 2-3 hours, strain, take 2 tbsp. spoons 3-5 times a day;
• Take mint tea in the morning and evening. To do this, pour a teaspoon of mint with a glass of boiling water, leave for 10-15 minutes, strain, take warm;
• infusion of motherwort herb. For this, 1 tbsp. Pour boiling water over a spoonful of herbs, leave for 2-3 hours, strain. Take half a glass 2 times throughout the day.

Consequences of inflammation

In cases of untimely consultation with a doctor, in most cases it is not possible to cure the disease on your own. This is extremely dangerous, as it may cause irreversible complications. The inflammatory process is transmitted to neighboring areas of the face, facial expressions are distorted, and the constantly present pain syndrome reduces the patient’s quality of life to zero.

Man can't lead full image life, he does not get enough sleep, is in a nervous constant voltage. In addition to all this, the occurrence of neuralgia against the background of tumor formation cannot be ruled out. Taking all these factors into account, you should visit a doctor on time and not self-medicate.

Prevention

In order to protect yourself from trigeminal neuritis, you should remember and follow simple rules. These include:

• timely treatment of the oral cavity. This includes treatment of teeth, throat and mouth infections;
• protect your face and head from injuries and injuries, explain to your children about the danger of facial injuries;
• timely treatment of heart diseases;
• avoid bad habits;
• proper nutrition, physical activity;
• get proper rest and sleep, try not to overwork;
• adequate response to stressful conditions, take care of your nerves, don’t get upset over trifles.

Keeping this in mind will help you reduce your risk of this disease and stay healthy and happy. Take care of yourself.

Recurrent lesion of the trigeminal cranial nerve, characterized by shooting paroxysmal prosopalgia. The clinical picture consists of repeated paroxysms of unilateral intense facial pain. Typically there is an alternation of phases of exacerbation and remission. Diagnosis is based on clinical data, neurological examination results, additional research(CT, MRI). The basis conservative therapy constitute anticonvulsant pharmaceuticals. Performed according to indications surgery: decompression of the root, destruction of the trunk and individual branches.

ICD-10

G50.0

General information

The first description of trigeminal neuralgia dates back to 1671. In 1756, the disease was identified as a separate nosology. In 1773, the British physician J. Fothergill made a detailed report on the pain syndrome characteristic of the disease. In honor of the author of the report, neuralgia was named Fothergill's disease. In modern neurology, the term “trigeminal (trigeminal) neuralgia” is more often used. According to the World Health Organization, the incidence is 2-4 people per 10 thousand population. Persons over 50 years of age are more susceptible to pathology. Women get sick more often than men.

Causes

Over the entire period of research into the etiology of this disease, various authors have mentioned about 50 causative factors. It has been established that in 95% of cases the etiofactor is compression of the trunk and branches of the trigeminal nerve. Among the main causes of compression are the following:

• Vascular pathology. Expansion, tortuosity, or aneurysm of a vessel lying next to the nerve trunk leads to irritation and compression of the latter. The result is pain. Predisposing factors are cerebral atherosclerosis and arterial hypertension.
• Volumetric formations. Cerebral tumors, neoplasms of the skull bones, localized in the area where the trigeminal nerve exits the cerebral trunk or along its branches, begin to compress the nerve fibers as they grow. Compression provokes the development of neuralgia.
• Changes in skull structures. The narrowing of bone canals and openings that occurs as a result of head injuries, chronic sinusitis, and otitis is of etiological significance. A change in the relative position of cranial structures is possible with pathology of the bite, deformation of the dentition.

In some cases, damage to the nerve sheath and fibers is caused by herpetic infection, chronic infectious process dental system (periodontitis, stomatitis, gingivitis). In some patients, trigeminal neuralgia develops against the background of a demyelinating disease. Factors that provoke the occurrence of pathology include hypothermia, dental procedures, increased chewing load, and in the case of infectious genesis - decreased immunity.

Pathogenesis

The above etiofactors potentiate morphological changes in the sheath of the trigeminal nerve. Research has shown that structural changes the myelin sheath and axial cylinders develop 3-6 months after the onset of the disease. Local microstructural disorders provoke the formation of a peripheral generator of pathologically enhanced excitation. Excessive impulses, constantly coming from the periphery, cause the formation of a central focus of hyperexcitation. There are several theories that explain the connection between local demyelination and the occurrence of a focus of hyperexcitation. Some authors point to the possibility of the emergence of transverse interaxonal impulse transmission. According to another theory, pathological afferent impulses cause damage to the trigeminal nuclei of the cerebral trunk. According to the third theory, at the site of the lesion, axon regeneration proceeds in the opposite direction.

Classification

Systematization of the disease according to etiology is of practical importance. This principle underlies the determination of the most appropriate therapeutic tactics(conservative or surgical). According to the etiological aspect, trigeminal neuralgia is divided into two main forms:

• Idiopathic (primary). Caused by vascular compression of the trigeminal root, most often in the area brain stem. Due to the difficulties in diagnosing pathological vessel-nerve relationships, idiopathic neuralgia is assumed after excluding other causes of trigeminal pain syndrome.
• Secondary (symptomatic). It becomes the result of neoplasms, infections, demyelinating pathology, and bone changes. Diagnosed using neuroimaging and cranial tomography.

Symptoms

The clinical picture consists of paroxysms of prosopalgia (facial pain), characterized by a series of intense pain impulses running from the lateral surface of the face to the center. Patients describe the pain syndrome as “electric shock”, “lumbago”, “electric discharge”. The attack lasts up to two minutes and is repeated many times. The localization of pain depends on the location of the lesion. With pathology of individual branches, pain impulses occur in the supraorbital region, along the zygomatic arch, and lower jaw. Damage to the trunk leads to pain spreading to the entire half of the face. The behavior of patients at the moment of paroxysm is characteristic: they freeze in place, are afraid to move, to speak. Despite the high intensity of pain, patients do not scream.

Trigeminal paroxysm is potentiated by various external influences: wind, cold air and water, shaving. Since the provoking factor can be the load on the facial and masticatory muscles, patients avoid opening their mouths wide, talking, laughing, and eating hard foods. Trigeminal neuralgia characterized by a relapsing course. During the period of remission there are no paroxysms. Subsequently, symptoms of loss of function of the trigeminal nerve appear - decreased sensitivity of the facial skin. The symptomatic form occurs with a combination of typical pain attacks and other neurological symptoms. Possible nystagmus, symptoms of damage to other cranial nerves, vestibular syndrome, cerebellar ataxia.

Complications

The fear of provoking neuralgic paroxysm forces patients to chew only with the healthy half of the mouth, which leads to the formation of compactions in the muscles of the contralateral part of the face. Frequent paroxysms reduce the quality of life of patients, negatively affect their emotional background, and impair performance. Intensive excruciating pain, constant fear the occurrence of another paroxysm can cause the development of neurotic disorders: neurosis, depression, hypochondria. Progressive morphological changes (demyelination, degenerative processes) cause a deterioration in the functioning of the nerve, which is clinically manifested by sensory deficits and some atrophy of the masticatory muscles.

Diagnostics

In typical cases, trigeminal neuralgia is easily diagnosed by a neurologist. The diagnosis is made based on clinical data and the results of a neurological examination. Main diagnostic criterion the presence of trigger points corresponding to the exit of the nerve branches in facial area. The presence of a neurological deficit indicates the symptomatic nature of the pathology. To clarify the etiology of the lesion, the following instrumental studies are used:

• CT scan of the skull. Allows you to identify changes in the size and relative position of bone structures. Helps diagnose narrowing of the foramina and canals through which the trigeminal nerve passes.
• MRI of the brain. It is performed to exclude a space-occupying lesion as a cause of compression of the nerve trunk. Visualizes tumors, brain cysts, areas of demyelination.
• MR angiography. Used for targeted verification of the vascular origin of compression. Informative if the size of the vascular loop or aneurysm is sufficiently large.

Trigeminal neuralgia is differentiated from prosopalgia of a vascular, myogenic, and psychogenic nature. The presence of a pronounced vegetative component (lacrimation, swelling, redness) indicates the vascular nature of the paroxysm, typical of cluster headache, paroxysmal hemicrania. Psychogenic facial pain is characterized by variability in the duration and pattern of painful paroxysms. To exclude ophthalmogenic, odontogenic and rhinogenic pain syndromes, consultation with an ophthalmologist, dentist, or otorhinolaryngologist is required.

Treatment of trigeminal neuralgia

Basic therapy is aimed at stopping peripheral and central focal hyperexcitation. First-line drugs are anticonvulsants (carbamazepine). Treatment begins with a gradual increase in dose until the optimal clinical effect is achieved. Maintenance therapy is carried out over a long period of several months, followed by a gradual reduction in dosage. In the absence of paroxysms, discontinuation of the pharmaceutical drug is possible. To increase the effectiveness of treatment anticonvulsants additional medications are used. Adjuvant therapies include:

• Drugs that potentiate the effect of anticonvulsants. Antihistamines help reduce swelling. Antispasmodics help relieve pain paroxysm. Microcirculation correctors (nicotinic acid, pentoxifylline) provide increased oxygenation and nutrition of the nerve trunk.
• Therapeutic blockades. Introduction local anesthetics, glucocorticoid hormones are carried out at trigger points. The treatment procedure gives a good analgesic effect.
• Physiotherapy. The use of galvanization with novocaine, ultraphonophoresis with hydrocortisone, and diadynamic currents is effective. The procedures reduce the severity of inflammation and have an analgesic effect.

The presence of an intracranial formation and insufficient effectiveness of pharmacotherapy are indications for surgical intervention. The feasibility of the operation is determined by the neurosurgeon. The basic techniques of neurosurgical treatment are:

• Microsurgical decompression. It is carried out in the area where the nerve exits the brain stem. It is necessary to remember the high risk of using the technique in elderly patients and patients with a burdened premorbid background.
• Percutaneous radiofrequency destruction. A modern alternative to open interventions with division of trigeminal branches. A significant disadvantage of the method is the relatively high percentage of relapses.
• Stereotactic radiosurgery. The operation consists of destruction of the sensory root by directed local gamma radiation. Side effects include loss of sensitivity in the area of ​​innervation of the destroyed root.

Prognosis and prevention

Trigeminal neuralgia is not life-threatening, but attacks of the disease are painful and debilitating. The outcome is determined by etiology, premorbid background, and duration of the disease. New onset trigeminal neuralgia in young patients with adequate treatment has a favorable prognosis. Relapses after surgery are 3-15%. Primary prevention consists of timely treatment of inflammatory pathologies of the dental system, ear, and paranasal sinuses. Measures secondary prevention are regular observation by a neurologist, exclusion of exposure to trigger factors, prophylactic use of anticonvulsants for colds.

The trigeminal nerve is the fifth pair of 12 existing cranial nerves. Trigeminal nerve ( name on Latin- nervus trigeminus) is the largest of the cranial nerves. Its name is closely related to the structure. The nerve consists of three main branches. The first two branches are sensitive ( sensory), the third branch of mixed structure - carries out sensory and motor functions. In addition, among the main dendritic branches of the nerve there are secretory branches responsible for the innervation of the glands of the facial area.

The branches of the nerve innervate certain facial areas, which is where they got their names:
Orbital ( visual) nerve – superior branch. Responsible for sensory sensations the following parts face: forehead, conjunctiva, upper eyelid, nasal mucosa, meninges, etc.;
Skulova ( maxillary) nerve – middle branch. Transfers sensory information from the nostrils, lower eyelid and upper lip, palate, upper teeth, sinuses, etc.;
Mandibular nerve - lower branch. Collects information from lower teeth, gums, lips, chin and lower part of the outer ear, etc. In addition, they provide the motor function of the innervated muscles.

According to the diagram, you can imagine the location of the nerve from its beginning to the periphery as follows. The motor nerve nuclei originate from the hindbrain region. The sensory fiber nuclei begin in the midbrain. Motor nerves emerge from the pons, forming a motor root, to which sensory fibers join the medulla, forming a sensory root. The motor and sensory roots together form a trunk that penetrates under hard shell cranial fossa and lies in a special depression located at the top of the pyramid temporal bone. In this area the trigeminal ( Gasserov) node from which three sensory branches of the nerve originate. Motor fibers are not part of the node. Their branch is located under the trigeminal ganglion, which exits through the foramen ovale and joins the mandibular branch. The number of nerve branches on the left side of the jaw is noticeably greater than on the right side.

Functions of the trigeminal nerve

Providing superficial and deep sensitivity of the face and mouth;
Security motor activity masticatory, temporal and other muscles of the head;

Embryonic development

The development of the brain and, above all, its structures that ensure the existence of the fetus in the first period after birth, begins from the third week of intrauterine development. There are several stages in the maturation of the neural systems of the brain. The cells of the trigeminal nerve nuclei mature most early in the first stage. The fibers of the nervus trigeminus cells grow earlier than the others towards the ancient cortex, and then towards the neocortex. Thanks to this, the young bark ( neocortex) is quickly involved in the implementation of adaptation processes. The nuclei of the trigeminal nerve take part in the formation of the sucking reflex in the unborn child.

Diseases

Trigeminal neuralgia is an attack ( paroxysm) severe, lightning-fast, sudden pain without obvious anatomical changes in the nerve trunk itself. Attacks are provoked by eating cold food, shaving facial hair in men, applying makeup, brushing teeth, etc. In the cool season, if you do not wear a hat, you can chill the nerves and provoke a paroxysm.

Causes of neuralgia:
injuries;
infection, one of the causes of which is carious teeth;
tumors;
nervous disorders, etc.

During an attack, pain can be felt on one side or simultaneously on both sides of the face. Usually the attack lasts several minutes. The pain may occur several times during the day. The disease is more common in middle-aged women.

Trigeminal neuritis is an inflammation of not only its sheath, but also the nerve itself.
Causes of neuritis:
viral (eg herpes) or bacterial infection;
injuries;
vascular disorders;
tumors, etc.

The disease is manifested by the following symptoms: attacks of pain of a varied nature, which do not always coincide with the zone of innervation of the nerve. When the disease occurs, damage can occur to either individual branches or the entire nerve. The severity of neuropathy depends on the form of the disease. At mild form the disease is practically not a concern. In severe forms, attacks cause a lot of suffering.

Diagnosis of diseases

The clinical picture of the disease consists of the patient’s symptoms and complaints. During the survey, feelings are clarified ( crawling, numbness, etc.), nature of pain ( shooting, pressing, bursting, etc..) and the time of its continuation. The pain of the nerve exit points is determined. Pain sensitivity is determined using a needle, and tactile sensitivity is determined using a cotton swab. The motor function of the third branch is determined by the following tests. The patient is asked to open his mouth wide, clench his teeth, and then unclench them. At this time, muscle tension and symmetry are noted.

The following instrumental research methods are used:
MRI of the brain, neck and face tissues. On MR tomograms, the centers of the trigeminal nerve, its exit areas and blood vessels are clearly visible;
electromyography helps to study the conduction of nerve impulses along nerve fibers;
An orthopantogram allows you to determine the causes of damage to the jaw branches of the nerve.

Nerve transplantation

Currently, specialists from Germany, Israel, and others are studying the transplantation of nerves from other parts of the body, as well as from a donor to the site of an atrophied or removed trigeminal nerve, as well as its branches.

Treatment and prevention

A neurologist treats diseases of the trigeminal nerve. In some cases, a trigeminal nerve block is performed by a dentist.

Drug treatment of many nerve diseases takes a leading place. Among the most effective drugs finlepsin ( synonym carbamazepine), prescribed in tablet form. The course of treatment is designed for long time. Under the supervision of a doctor, the dosage of the drug is increased or decreased. Independent, uncontrolled increase in dose medicine is fraught with undesirable consequences in the form of disruption of the liver and kidneys. In addition, painkillers are prescribed. If conservative treatment is not effective, then a neurosurgical operation is prescribed - microvascular decompression. The purpose of this operation is to install a Teflon protector between the nerve and the vessel in order to eliminate pathological impulses.

For neuralgia or neuritis to relieve attacks severe pain blockades are carried out. First, painful points are determined, into which a solution of local anesthetic is injected ( novocaine). Diseases cannot be treated with blockades, since they only provide temporary pain relief.

In folk medicine, many recipes are used that help eliminate pain. Proven folk recipes:
plucked geranium leaves should be applied to the sore spot and wrapped in a downy scarf. The pain will soon begin to subside;
drink a quarter glass 3 times a day of warm chamomile decoction, etc.
During remission, massage is indicated, in which the main techniques are stroking, rubbing and vibration.
Disease prevention is closely related to in a healthy way life, as well as with a warning chronic diseases sinuses of the nasopharynx, teeth. It is important to treat on time colds in the acute stage.

Inflammation of the trigeminal nerve on the face, or trigeminal neuralgia, is a serious and insufficiently studied disease.

In total, humans have 12 pairs of cranial nerves, the largest of which is the trigeminal nerve (V pair).

It is mixed, containing both sensory and motor nerve fibers.

Therefore, trigeminal neuralgia is manifested by a violation of the sensitivity of certain facial zones, and in some cases, a violation of the motor function of the lower jaw.

The pathogenesis is not fully understood, but experts identify several main reasons contributing to the occurrence of the disease:

Mechanical compression: the nerve where it exits the cranial pons can be compressed by various pathological formations. There are several reasons for this compression:

• Vascular diseases leading to nerve compression: aneurysms ( pathological changes blood vessels), atherosclerosis (thickening of the vascular wall), strokes or increased intracranial pressure.
• Tumor processes: various neoplasms of the brain or facial part of the skull, which during growth can compress the area of ​​the trigeminal nerve.
• Injuries that result in the formation of post-traumatic cysts or scars that compress the nerve.
• Congenital anomalies of the skull bones.

Herpetic infection: one of the herpes viruses - Herpes zoster - causes 2 diseases in humans: upon initial entry into the body (usually in childhood) - This chicken pox. After an infection, the virus persists (is in an inactive state) in the body throughout life and, with a decrease in immunity, can manifest itself as another disease - herpes zoster.

This disease is no longer as harmless as chickenpox, because... affect the sensory nerves (in particular, the trigeminal), along which herpetic eruptions are localized. Postherpetic trigeminal neuralgia occurs.

Diseases nervous system : some pathologies, for example, multiple sclerosis, children's cerebral paralysis, epilepsy, meningitis can lead to demyelination of the nerve.

Odontogenic causes:

• jaw injuries;
• bacterial tooth infection;
• consequences dental treatment(fillings, tooth extraction, etc.).

A disease like this brings real suffering to a person, because the pain can be so severe that no painkillers help. What is the cause of this pathology?

Read more about the symptoms and treatment of trigeminal neuritis.

Medicines and surgery are not always prescribed for trigeminal neuralgia. In such cases, you can escape from pain with folk remedies. Follow the link for a selection of home remedies for pain relief - herbs, cereals, oils.

Development mechanism

As a result of the influence of certain factors on the trigeminal nerve, its demyelination occurs. In other words, damage occurs to the myelin sheath of the nerve, leading to disruption of its conductivity.

Conduction pathology causes a violation of the inhibition of nerve impulses, as a result of the trigeminal nerve nucleus (located in the middle and hindbrain) become overirritated. This is how pain syndrome starts.

The trigeminal nerve at its exit from the skull is divided into 3 branches:

• orbital nerve;
• maxillary nerve;
• mandibular nerve.

These branches provide sensitivity to the skin and mucous membranes of the face, tissues of the cranial vault, as well as parts of the dura mater. The motor part of the trigeminal nerve innervates the masticatory muscles.

Location of facial nerves

Therefore, depending on which branch of the nerve is affected, changes in sensitivity and pain may vary. facial areas. In case of defeat:

• I branch - in the area of ​​the upper eyelid, eyeball, inner corner of the eye, nose, forehead and scalp.
• II branches - in upper jaw(including in teeth and maxillary, or maxillary sinus), upper lip and cheek, in the area of ​​the lower eyelid and outer corner of the eye;
• III branches - in the lower jaw (including in the teeth), lower lip, chin, lower part of the oral mucosa and tongue, anterior parotid region, paralysis of the masticatory muscles also occurs;

Signs and symptoms of inflammation

Painful attacks with trigeminal neuralgia can be of two opposite types:

• intense shooting pain lasting up to 3-4 minutes;
• prolonged, burning, debilitating pain that lasts up to several days.

The pain is one-sided, because usually only one of the trigeminal nerves is damaged. In most cases, the pain covers the areas of innervation of the II and III branches (the area of ​​the first branch only in 5% of cases).

At the moment of an attack of neuralgia, a person freezes, afraid that unnecessary movements will further increase the unbearable pain. Sometimes patients may rub their cheek to try to relieve the attack. Pain can cause spasm of the muscles of the affected part of the face (pain tic).

There are trigger zones on the face, irritation of which provokes an attack of neuralgia. Most of these “pain” points are located in the area of ​​the nasolabial triangle.

In addition, pain may occur during normal daily activities:

• when talking, laughing;
• when sneezing, yawning;
• while chewing;
• when washing and brushing teeth, shaving, etc.

Several factors may contribute to the development of an attack: diseases of the ENT organs (sinusitis, sinusitis, rhinitis), acute respiratory viral infections, nervous overexcitation, consumption of certain foods (spicy foods, alcohol, chocolate, etc.), migraine attacks.

During the period between attacks, there is no pain and the disease does not bother the patient in any way, but pain can appear at any time, it is so strong and debilitating that it greatly affects the general condition of a person, including mental health.

Consequences of trigeminal neuralgia

A long course of the disease can leave permanent changes on the face, because... There is a disturbance in blood and lymph circulation in the affected area, and tissue nutrition deteriorates accordingly (trophic disorders). In addition, fearing that unnecessary movements will cause an attack of neuralgia, the patient begins to spare the affected half, which can lead to muscle wasting (they become thinner, their function decreases).

All this manifests itself as follows:

• facial asymmetry;
• dry skin on the affected side;
• drooping upper eyelid;
• grin (raised corner of the mouth);
• loss of eyelashes and eyebrows;
• local hair loss or graying;
• unilateral diseases of teeth and gums (periodontal disease, etc.);
• excessive tension in the facial muscles of the healthy half.

In addition, debilitating painful attacks and constant fear of a new outbreak lead to mental disorders. Patients become nervous and irritable and experience constant feeling anxiety and fear, become withdrawn, uncommunicative, and sad.

The disease can lead to the formation of neurosis, depression, phobia in a person, or even cause a desire to commit suicide.

Diagnosis of the disease

Survey: during the survey, they find out whether the patient has complaints characteristic of neuralgia (described above).

Characteristic features are specified:

• sudden onset;
• alternation of painful attacks with periods of well-being;
• the process is one-way;
• irritation of trigger zones provokes an attack;
• ineffectiveness of painkillers and anti-inflammatory drugs.

The interview also reveals whether the patient has a history of factors or diseases that contribute to the development of pathology (vascular disease, tumors, head injuries, herpes virus infection, etc.).

Examination: the patient avoids palpation of “painful” areas on the face. Over a long period of time, facial changes may be observed (described above). General state the patient is usually satisfactory.

If the examination is carried out at the time of the attack, then you can see the characteristic clinical picture: the face is distorted by pain, the patient tries to take a motionless position or kneads his face with his hands, redness of the skin on the affected side is observed, lacrimation and profuse salivation are possible. The pulse usually quickens and blood pressure may rise.

Instrumental methods:

• Computer (CT) and magnetic resonance imaging (MRI) - to examine for the presence of brain tumors, pathologically altered blood vessels, and signs of multiple sclerosis.
• Electroneurography – reveals pathological changes in the conductivity of a specific nerve.
• Electroencephalography (EEG) - during the study, it is possible to identify brain structures in which conduction is impaired or, for example, changes in the locations of the trigeminal nerve nuclei.

Laboratory diagnostics: generally uninformative when making a diagnosis. However, if the anamnesis contains data for herpes infection, you can test your blood for the presence of antibodies to the Herpes zoster virus.

Treatment of inflammation of the trigeminal nerve on the face

Drug therapy:

• Antiepileptic drugs are the main treatment for trigeminal neuralgia. Carbamazepine (Finlepsin) is most often used; phenytoin, gabantine and others can also be used.

These drugs are prescribed only by a doctor, the dose is selected individually. When a lasting effect from treatment is achieved, the dose of the antiepileptic drug is gradually reduced.

The maintenance dose is taken by the patient for a long time or for life to prevent the occurrence of new attacks of neuralgia.

• Muscle relaxants (baclofen, mydocalm) – reduce nervous excitability, cause muscle relaxation and have an analgesic effect.
• B vitamins – help restore nerve fibers.
• Sedatives and antidepressants – to reduce the patient’s psycho-emotional stress.

Surgical treatment– if conservative therapy is ineffective:

• Microvascular decompression is a neurosurgical operation that eliminates the impact of a pathologically altered vessel on the trigeminal nerve (a protector is installed between the vessel and the nerve).
• Removal of tumor formations leading to nerve compression.
• Removal of the trigeminal nerve - performed in extreme cases, because persistent side effects may remain, for example, changes in facial expressions.

Only the basic methods are indicated here, because... Treatment of trigeminal neuralgia is complex and depends on individual factors and patient characteristics. Only qualified specialist will be able to assess the severity of the process and choose the required amount of treatment in each specific case. Therefore, in no case should you self-medicate and delay a visit to the doctor.

Medications are usually used to relieve pain from trigeminal neuralgia. comes down to taking antispasmodics, muscle relaxants and anticonvulsants.

How to relieve inflammation of the trigeminal nerve and how to determine this pathology, read the article.

Video on the topic

The trigeminal nerve is an important component of the entire human nervous system. It is responsible for almost all processes occurring with the face– facial expressions, sensitivity, jaw work. Inflammation of the trigeminal nerve is a rather complex problem, as it is accompanied by significant pain and, if left untreated, severe consequences.

Localization

To understand where the trigeminal nerve is located, you can look at the photo.

The trigeminal nerve originates in the temporal region (near the ear) and then leaves a triple branch. The branching consists of three different directions:

• Ophthalmic branch.
• Branch leading to the upper jaw.
• Mandibular nerve.

In turn, many more branches branch off from the main large branches of this nerve process. small vessels which spread all over the face. Thus, this nerve process controls the functioning of all facial muscles.

Causes of inflammation

Trigeminal neuralgia (trigeminal neuralgia) is a disease accompanied by severe inflammatory process. The causes of inflammation of the trigeminal nerve can be its pinching or disturbances in the circulatory process. The following internal conditions can provoke compression:

• tumor-like formations;
• injuries and adhesions;
• pathological dilation of cerebral vessels;
• congenital anomalies of the skull bones.

TO external factors, causing inflammation, include:

• dental problems (gingivitis, periodontitis, periodontal disease, incorrect treatment or dental prosthetics);
• inflammation of the sinuses.

Inflammation of the trigeminal nerve on the face can also be caused by various diseases nervous and cardiovascular system:

• atherosclerosis;
• multiple sclerosis;
• epilepsy;
• meningitis;
• encephalopathy.

The trigeminal nerve on the face can become inflamed due to damage to the human body by severe viruses or infection (herpes, meningitis, neuroAIDS, tetanus, botulism, tuberculosis, herpes zoster, malaria, polio, etc.).

Another cause of trigeminal neuralgia is severe hypothermia of the head and face. That is why children are taught from childhood to put on a hat before going outside.

Trigeminal nerve disease can sometimes be triggered by completely extraneous factors and conditions:

Symptoms

Symptoms of inflammation of the trigeminal nerve can be divided into conditional primary and secondary symptoms.

Pain syndrome

The first and main symptom of inflammation of the trigeminal nerve is pain. It can torment the patient for several days, weeks or months. After some time, even without appropriate treatment pain may disappear, but this in no way indicates that the disease has receded.

The pain is localized in the places where the trigeminal nerve passes, that is, only one part of the face hurts. The starting points for the onset of pain syndrome can be the temple, wings of the nose, corners of the mouth, and jaw. The location of the pain in the jaw area very often prevents the doctor from making an accurate diagnosis. The fact is that the same manifestations are characteristic of toothache caused by dental problems.

Painful sensations when the trigeminal nerve is damaged appear in the form of acute, piercing, short-term spasms. Such spasms are almost impossible to calm by taking painkillers. They can occur during palpation of the face, chewing, facial expressions, or simply out of the blue.

Pain with trigeminal neuralgia is conventionally divided into two types:

1. Typical.
2. Atypical.

Typical pain manifests itself as sudden, paroxysmal spasms spreading over the entire right or left side of the face. Such spasms are somewhat reminiscent of electrical discharges. Typical pain comes on suddenly and goes away just as quickly. Its duration does not exceed a couple of minutes, and the frequency can reach several times an hour, but after a couple of hours it completely disappears.

Atypical pain can be identified by prolonged, severe pain for a whole day or several days. The pain syndrome can be located throughout the face and be accompanied by a tic.

Secondary symptoms

If the trigeminal nerve is inflamed, then along with unbearable pain the patient may experience other manifestations:

• swelling and redness of the eyelids;
• uncontrolled, increased salivation;
• tearing eyes;
• numbness of the face;
• sleep problems;
• weakness and chills;
• muscle spasms;
• facial asymmetry;
• pallor and redness of the skin;
• dryness or increased fat content skin;
• rashes and itching on the skin of the face;
• headache;
• painful tic on the face;
• distorted facial expressions and grimaces;
• increased body temperature;
• insomnia, irritability, anxiety.

In the following image you can see how the face changes with neuralgia facial nerve:

Diagnostics

Human anatomy is such that it is not always possible to diagnose accurate diagnosis. That is why it is sometimes quite difficult to diagnose by eye whether the trigeminal nerve hurts or whether it is due to another disease.

Any doctor, in order to find the cause and source of the disease, must conduct a correct diagnosis. When treating the trigeminal nerve, it consists of a conversation with the patient, examination and palpation of his face, and review of the hospital card.

Very often an MRI or CT scan must be done to accurately determine the diagnosis. In Moscow you can contact some treatment centers for carrying out the procedure of electroneurography, electroneuromyography or electroencephalography. Similar instrumental methods research allows us to have a more accurate picture of the disease.

Treatment methods

Treatment of inflammation of the trigeminal facial nerve should be carried out in accordance with certain rules. First, it is necessary to relieve the pain syndrome, then begin to treat the underlying disease that caused the neuralgia, and at the same time eliminate the inflammation that has arisen in the place where the trigeminal nerve is located. In order to thoroughly restore his health, the patient will have to stay in the hospital for at least several weeks, and only then continue to be treated at home.

During the treatment of the trigeminal facial nerve, the following medications can be used:

Sometimes trigeminal neuralgia is treated with alcohol blockades. To do this, the patient is given an injection with a solution of alcohol and novocaine. But in this case, doctors need to be aware that the patient may begin to bleed or develop a hematoma at the site of the skin puncture.

Another method of treating the trigeminal nerve is therapeutic massage. Many patients find this technique quite effective and the most harmless.

Treatment at home

Treatment of inflammation of the trigeminal nerve at home is impossible. In order to recover from such a complex disease, it is necessary to first undergo a thorough diagnosis, and only then determine a treatment regimen. Required condition proper therapy is to consult a doctor in a timely manner. Only he will be able to identify this ailment and prescribe medicine.

Before treating inflammation of the trigeminal nerve with folk remedies, you must consult a doctor. Sometimes doctors allow the use alternative medicine as aids. But the main therapy should still be carried out with medication.

Operation

The picture shows what surgery to restore the trigeminal nerve looks like.

In cases where drug treatment does not produce adequate results, surgical intervention may be prescribed. The same tactics are relevant when pressure is applied to the trigeminal nerve from the outside. Pressure from a brain tumor or blood vessel can damage and inflame this nerve process.

There are two types of such an operation:

1. Microvascular decompression.
2. Radiofrequency destruction.

The choice of operation must be determined by the surgeon himself. During microsurgical decompression, trepanation of the posterior part is performed cranium, and in the space between the root of the trigeminal nerve and the vessels pressing on it, a special material is placed that performs the function of a gasket. This technique does not give the vessel the opportunity to damage the root.

With radiofrequency destruction, radio waves are directed to the affected areas of the roots and destroy them.

Complications

If available specified symptoms If you do not consult a doctor in time and do not cure the neuritis, the following consequences are very likely to occur:

• hearing problems;
• violation of taste buds;
• constantly pursuing pain;
• atrophy or paresis of facial muscles;
• dysfunction of the central nervous system;
• problems with the nervous system.

To summarize, it is worth saying that prevention is always the best treatment. And in order to prevent the trigeminal nerve from getting sick, you must avoid stressful situations, hypothermia and acute viral diseases.