Neuralgia is defined as an intense burning or stabbing pain caused by irritation of or damage to a nerve. The pain is usually brief but may be severe. It often feels as if it is shooting along the course of the affected nerve.
Different types of neuralgia occur depending on the reason the nerve has been irritated.
Neuralgia can be triggered by a variety of causes, including tooth decay, eye strain, or shingles (an infection caused by the herpes zoster virus). Pain is usually felt in the part of the body that is supplied by the irritated nerve.
Trigeminal neuralgia is a condition that affects trigeminal nerve. Excruciating, shooting stabbing pain in area of distribution of trigeminal nerve.
What is Trigeminal Nerve?
The trigeminal nerve is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewing.
Term trigeminal word is derived from tri – three; germinal – branches. Nerve has three major branches: the ophthalmic nerve, the maxillary nerve, and the mandibular nerve .
Ophthalmic nerve – The ophthalmic nerve supplies branches to the cornea, ciliary body, and iris; to the lacrimal gland and conjunctiva; to the part of the mucous membrane of the nasal cavity; and to the skin of the eyelids, eyebrow, forehead and nose.
Maxillary nerve -It comprises the principal functions of sensation from the maxillary, nasal cavity, sinuses, the palate and subsequently that of the mid-face, and is intermediate, both in position and size, between the ophthalmic nerve and the mandibular nerve.
Mandibular nerve – is the largest of the three divisions of the trigeminal nerve. In general, the mandibular nerve supplies the lower face for sensation over the mandible, including the attached teeth, the temporomandibular joint (TMJ), and the mucous membrane of the mouth as well as the anterior two-thirds of the tongue
Trigeminal neuralgia most commonly involves the middle branch (the maxillary nerve) and lower branch (mandibular nerve) of the trigeminal nerve.
Causes of Trigeminal Neuralgia ?
- Irritation of the nerve due to adjacent artery, vein, tumor, cyst etc.
- Physical damage to the nerve: This could be the result of injury, a dental or surgical procedure, or infection.
- Multiple sclerosis – Demyelization (destruction of myelin sheath) occurs due to auto-immune disease. Myelin sheath is the insulating covering of the nerve.
Clinical features of Trigeminal Neuralgia
- Unilateral facial pain: paroxysmal, severe shooting or stabbing (like an electric shock).
- Burning pain in area of distribution of nerve.
- Pain lasts several seconds (in rare cases, several minutes) and may appear up to 100 times per day
- Typically shoots from mouth to the angle of the jaw on the affected side in most cases.
- Occurs either at rest or triggered by movements such as chewing, talking or touch (e.g., brushing teeth, washing face); becomes worse with stimulation.
- Pain is unilateral but may affect both sides.
- Facial spasms may occur
- Psychological distress due to severe pain.
- Severe depression with suicidal tendencies
Diagnosis of Trigeminal Neuralgia
- Clinical symptoms are major tool for diagnosis of Trigeminal neuralgia including history duration and extension of pain.
- Dental X-Ray is recommended to rule out dental caries.
- Other investigation such as MRI is suggested in some cases.
Conventional Treatment of Trigeminal Neuralgia
- Trigeminal neuralgia is usually managed conservatively. Drug of choice is carbamazepine
- Surgery is indicated if conservative treatment is not sufficiently effective. In cases of symptomatic trigeminal neuralgia, treatment of the underlying condition should be considered.
- Subsequent coexisting conditions (e.g., depression) should be managed as appropriate.
Homeopathic Remedies & Homeopathy Treatment for Trigeminal Neuralgia
Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of Trigeminal neuralgia. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting a remedy. To study any of the following remedies in more detail, please visit our Materia Medica section. None of these medicines should be taken without professional advice.
Commonly indicated homeopathy medicines for Trigeminal Neuralgia
- Argentums nitricum
- Magnesia phosphorica
- Calcarea carbonica
- There are violent cutting pains coming on towards evening, most violent about midnight; the paroxysms are of long duration and there are symptoms of vascular excitement;
- The pains radiate to temples, ears and nape; are worse from noise, motion , jar, chewing, cold air, etc., and are relieved by absolute rest and warmth.
- The pains come and go suddenly and hyperaesthesia marks the remedy.
- The more purely nervous the affection the more effective is Arsenicum.
- It has the well-known intermitting burning, stinging, hot needle-pain, the distressed countenance, the restlessness and the periodicity.
- It holds the first place in neuralgias, especially of malarial origin, neuralgias from influenza or simple debility with great aggravation at approach of night, and relief from external heat.
- The pain is severe and drives the patient from place to place.
- It suits especially infra-orbital forms with a Hippocratic countenance during the attack.
- A useful remedy where there is a constrictive pain, numbness, profuse lachrymation, worse at night and at rest.
- The pains are cramping, causing numbness and tingling; pain at the root of the nose or in the other part of the body as if squeezed in a vise.
- The pains also increase gradually and decrease gradually.
- Neuralgias from hollow teeth, especially suitable to old people with a mouth full of hollow stumps, which pain violently at times.
- Platinum suits especially hysterical subjects who have profuse, thick, black exhausting menses.
- Skin symptoms, affections of bones, and neuralgias most important, especially about teeth and face.
- This remedy is indicated by the spreading character of the pains, and the aggravation from warmth; they are accompanied with chilliness and sensitiveness.
- Violent neuralgia about face and teeth, running towards ear, at night; worse, eating; better near hot stove. Roots of teeth decay.
- There is a stupefying pressure and the pains are worse at the midnight hours.
- After the attack there is a numbness remaining.
- Has a pronounced action on the inferior maxillary branch of the fifth pair of the cranial nerves; on the ear; and respiratory tract and bladder.
- Neuralgia affecting zygoma, temporo maxillary joint, and ear (Menyanth), particularly of left side, with lachrymation, coryza, and sensation as if parts were crushed with tongs.
- Talking, sneezing, and change of temperature aggravate the pains; also, pressing teeth together.
- Pains seem to come in flashes, excited by least movement, occurring periodically at same hour in morning and afternoon each day.