How to cure inflammation of the trigeminal facial nerve. Inflammation of the trigeminal nerve: causes, symptoms and treatment

Neurologist, UZ 10 City Clinical Hospital
Kalupina I.G.

Trigeminal neuralgia is compression, irritation, or inflammation of the trigeminal nerve. The disease causes severe pain in the face. More than a million people on the planet suffer from trigeminal neuralgia. The disease most often develops after 40 years. Women are more susceptible to the disease than men.

How does trigeminal neuralgia occur?

The trigeminal nerve is the fifth of twelve pairs of cranial nerves. One trigeminal nerve is on the left side of the face, and the second is on the right. The trigeminal nerves provide sensation to the eyes, eyelids, forehead, cheeks, nostrils and lips.

Trigeminal neuralgia occurs when the trigeminal nerve is compressed or irritated. Often the disease is preceded by destruction of the nerve sheath. The nerve endings become exposed and react to any impact with an attack of pain. The pain comes on suddenly. It may be preceded by a car accident, dental treatment, or swipe in the face.

Causes of trigeminal neuralgia

Distinguish following reasons trigeminal neuralgia:

compression of the trigeminal nerve by tortuous vessels or a tumor;
multiple sclerosis;
meningitis;
diseases paranasal sinuses nose;
malocclusion;
vascular aneurysms;
herpes, which affects the trigeminal ganglia;
hypothermia, injuries, shocks, consequences of concussions;
viral infection, cold, bacterial infection throat and upper respiratory tract.

An attack of trigeminal neuralgia can occur when a person washes his face, shaves, brushes his teeth, talks or smiles. Most often, the disease occurs in older people with metabolic disorders or cardiovascular diseases.

Symptoms of trigeminal neuralgia

The main symptom of the disease is severe excruciating pain in the face. It usually occurs in the upper or lower jaw. At first a person thinks that he has problems with his teeth. However, after dental treatment the pain does not go away. It intensifies during eating, talking, and after hypothermia.

Pain with trigeminal neuralgia can be typical or atypical.

Typical pain is cyclical: it either intensifies or subsides. Shooting pain, similar to an electric shock, begins with touching a certain area of the face. Painful sensations localized in the lower part of the face, less often around the nose or eyes. Some patients experience pain attacks once a day, others every hour.

Not typical pain It occurs less frequently and is felt constantly. It involves more of the face than typical pain. With this form of the disease, the pain may not subside. This kind of neuralgia is more difficult to treat.

Other symptoms of inflammation of the facial trigeminal nerve: tearing, increased salivation, numbness or increased sensitivity in the area of the lips, eyelids, nose, redness of the facial skin, involuntary contractions of the facial muscles.

Why is inflammation of the trigeminal nerve dangerous?

Without proper treatment the disease leads to serious complications:

paresis of facial muscles;
cerebellar hematoma;
hearing impairment;
damage to the nervous system - ataxia.

Due to frequent attacks of pain, a person develops depression, he cannot eat normally, he loses weight, and his immunity weakens. Constant pain can disrupt the psyche, the patient avoids communication.

Treatment of trigeminal neuralgia

Treatment methods for trigeminal neuralgia include: conservative measures, so radical methods, in particular, surgical intervention, as well as minimally invasive procedures.

Conservative treatment consists of prescribing various medications and physiotherapeutic methods. Usually, drug treatment can be very effective. But, as the disease progresses, drug therapy becomes ineffective or even ceases to relieve attacks of pain. In addition, any drug therapy carries a risk of side effects. In this case, doctors resort to surgical treatment.

Conservative treatment of trigeminal neuralgia

In drug treatment for trigeminal neuralgia, various groups medicines, among which are:

Anticonvulsants. The most commonly used anticonvulsant is carbamazepine, a very popular and effective remedy for relieving attacks of pain associated with trigeminal neuralgia. In addition to it, other drugs in this group are also used, such as lamotrigine, phenytoin and gabapeptin.

If necessary, when the effect of anticonvulsants decreases, their dose may be increased, or the doctor may prescribe another drug. Therapy anticonvulsants can also lead to side effects, including dizziness, drowsiness, visual disturbances (double vision) and nausea.

Antispasmodics and muscle relaxants. Typically these drugs are used in combination with anticonvulsants. Baclofen is most often used in combination with carbamazepine or phenytoin. They can also be prescribed in isolation.

Alcohol blockades of the trigeminal nerve

Alcohol blockades of the trigeminal nerve lead to the so-called. freezing of the affected area of the face, which is accompanied by a pronounced analgesic effect. This ethanol injection is carried out in the area where one of the branches of the trigeminal nerve passes, which is affected. The effect of such injections is short-lived, and the pain inevitably recurs later, but it is worth noting that even one day without pain is very important for such patients, especially if pain occurs even from rinsing the face. Over time, you have to re-inject.

In addition, there is a risk of complications from such injections in the form of bleeding, a small hematoma if a blood vessel is damaged, and nerve damage. Injection of ethyl alcohol is carried out by intraneural administration in an amount of 1-2 ml. Typically used 80% solution of alcohol in combination with novocaine. In this case, first 1-2 ml of 2% novocaine is administered, and then, after reaching conduction anesthesia- alcohol. This procedure is most often performed on an outpatient basis, but requires special skill and experience from the doctor in performing such injections.

Surgical treatment of trigeminal neuralgia

At surgical treatment Trigeminal neuralgia, the doctor tries to eliminate the compression of the nerve trunk by the blood vessel. In other cases, the trigeminal nerve itself or its node is destroyed in order to relieve pain. Surgical treatments for trigeminal neuralgia are often minimally invasive. In addition, to surgical method refers to the so-called Radiosurgery is a bloodless intervention that does not require any incisions or stitches.

Prevention

treat teeth, sinusitis, sinusitis, acute infections in a timely manner;
eat more fresh fruits and vegetables to strengthen the immune system;
to harden;
avoid drafts, hypothermia, stress, injuries, intoxication;
play sports: swimming, dancing, running;
avoid drafts, hypothermia, stress;
limit alcohol consumption, do not smoke.

Physiotherapy

Before performing gymnastics, consult your doctor. Do exercises in front of a mirror to control the process. Include the following exercises in your gymnastics:

Perform smooth head rotations for 2 minutes, first clockwise, then counterclockwise.
Pull your head and neck first to your right shoulder, then to your left. Repeat the bends 4 times on each shoulder.
Stretch your lips into a smile, then gather them into a “tube”. Repeat the exercise 6 times.
Take air into your cheeks and exhale through the narrow gap in your lips. Repeat 4 times.
Make a “fish”: pull in your cheeks and hold in this position for several seconds. Repeat the exercise 6 times.
Close your eyes tightly, then open them wide, repeat 6 times.

Treatment of inflammation of the trigeminal nerve (neuralgia) is carried out using various methods, but is it really possible to do this at home? We will try to answer in detail in today’s material.

This disease is insidious - painful symptoms overtake the victim suddenly and he will have to go a long way to get rid of them.

Description

So what is neuralgia and what are the problems of the disease? The trigeminal nerve is three branched nerves that run along both sides of the face: one of the branches is located above the eyebrows, the other two are on both sides of the nose and in the lower jaw.

Inflammation of this nerve is extremely painful and has a specific nature, the consequences of which are literally visible. When affected, pain appears in the forehead, nose, brow ridges, jaw, neck and chin. Possible severe attacks toothache. At the same time, nervous twitching, paleness or redness of the skin, and atrophy of the facial muscles also occur.

The disease occurs due to various reasons– it can be independent or a consequence of various infections, overwork and stress. If you notice signs of neuralgia, you should not delay seeing a doctor and begin treatment as quickly as possible.

Types of inflammation

Since each part of the trigeminal nerve is divided into smaller branches that lead to all areas of the face, the nerve covers it as a whole. These branches are responsible for facial sensitivity.

The first branch is responsible for the eyebrow, eye, upper eyelid and forehead. The second - for the nose, cheek, lower eyelid and upper jaw, the third - for some masticatory muscles and the lower jaw.

There are two types of disease:

type one (true): the most common, occurs due to impaired blood supply or compression of a nerve, and is independent. In this type, the pain is severe, periodic and piercing;
type two (secondary): a symptom, often a complication of a previous disease, arising as a result of complications of other diseases. With neuralgia of this type, the pain is burning and constant, and can occur in any part of the face.

The most popular cases of neuralgia of the nerve process are only on one side of the face, however, there are cases of inflammation of two or three branches at once, sometimes on both facial sides. The pain is intense, attacks last for 5-15 seconds, often reaching several minutes.

Causes

Doctors are still unable to determine the exact factor why neuralgia occurs, but there are a number of reasons that contribute to the appearance and development of the disease:

Compression of the trigeminal nerve can be internal or external. Tumors and adhesions formed after injuries, as well as a displacement of the location of arteries and veins near the trigeminal nerve are usually classified as internal. Inflammation in the oral cavity and nasal sinuses is classified as external factors;
hypothermia of the face area – occurs among those who do not prefer to wear a hat in winter. If the nerve is cold, even washing with cold water can provoke an attack of neuralgia;
signs of an immune malaise in the body, against the background of which herpes has become more active - in this case, antiherpes drugs help;
diseases of the oral area are an additional impetus for neuralgia: periodontitis, gingivitis, gum abscess, periodontitis and other types of caries complications are also very dangerous. If the filling is placed incorrectly (the material extends beyond the top of the tooth) or the patient is injured during tooth extraction, this can also be the cause;
herpes zoster is a disease that is viral in nature and becomes more active if the body is weakened; as a result of reproduction, it develops an inflammatory process of the trigeminal nerve;
“hunger” of the nerve is the accumulation of cholesterol plaques on the walls of blood vessels.

To get rid of inflammation, you should take treatment:

some forms of allergies;
endocrine system disorders;
metabolic failure;
depression and insomnia;
neurosis;
cerebrovascular diseases;
psychogenic disorders;
multiple sclerosis;
hepatic infection;
reduced immune system.

The etiology of neuralgia is indeed wide, but it is generally accepted that it usually affects women aged 45 to 70 years. With age, immunity decreases and any exercise stress may cause an attack of illness.

Video: trigeminal neuralgia in the “Live Healthy” program with Elena Malysheva.

Symptoms of inflammation of the trigeminal nerve

Many patients complain of sudden and causeless pain, but also note the occurrence of neuralgia after stressful situations. Doctors are inclined to believe that the inflammation developed earlier - stressful situation triggered the pain.

The branches of the trigeminal nerve affect motor and sensory fibers, and sharp pain, spasms in the masticatory muscles, all these symptoms indicate inflammation.

Symptoms of facial nerve damage are:

acute piercing pain in one of the halves of the face, which has a through nature;
distorted facial expressions due to skewed individual areas or in the area of one half of the face;
headaches, chills, general weakness, muscle pain throughout the body;
increased body temperature (hyperthermic reaction of the body);
with severe pain – insomnia, fatigue and irritability;
muscle twitching near the affected nerve;
a small rash in the affected area of a certain part of the face.

Severe shooting pain from the ear region to the midline of the head indicates the main manifestation of neuritis, after which a gross distortion of the face appears. Such changes may remain lifelong if the disease becomes protracted or progressive.

If the disease persists for a long time, paleness or redness of the skin, changes in the secretion of glands, greasy or dry skin, swelling of the face and even loss of eyelashes are possible.

Neuralgia pain is divided into two types:

Typical pain is sharp and intense, periodic, and can fade and recur. With neuritis, the shooting, similar to a toothache, resembles an electric shock and lasts about 2-3 minutes. It affects only one part of the face and is localized depending on which part of the triple nerve is damaged. After paroxysmal pain, it is replaced by aching pain. painful sensations.
Typical pain can be triggered by washing, brushing teeth, shaving, applying makeup - actions affecting one of the parts of the face. Pain appears during laughter, smiling and talking, most often occurring after exposure to low temperatures on one of the halves of the facial and ear areas.
Atypical pain is constant with short breaks, covers most of the face, making it difficult for the patient to determine its source. It happens that a painful attack is accompanied by muscle spasm, then a painful tic occurs on the affected side of the face. Their sudden contraction looks like abnormal facial asymmetry and is accompanied by pain, and the victim cannot open his mouth until the attack ends. It is much more difficult to treat, since the pain torments the patient every hour, reaching its peak in 20 seconds, after which it continues for some time.

Anatomy diagram, photo

The trigeminal nerve is located in the temporal zone, where its three branches are located and pass:

Up – frontal and ocular parts.
Lower jaw.
Upper jaw

The first two branches have sensitive fibers, the last one has sensory and masticatory fibers, providing active muscular movements of the jaw.

Diagnostics

In diagnosing pathology, it is important to consult a doctor in time to assess the pain syndrome and carry out neurological examination. The diagnosis is based on the patient’s complaints, the specialist determines the type of pain syndrome, its triggers, localization and possible places damage causing pain.

To determine the affected area and find out which branch of the trigeminal nerve is damaged, the doctor palpates the patient’s face. Additionally, an examination is carried out for the presence of inflammatory processes in the facial area - sinusitis, sinusitis, frontal sinusitis.

The following instrumental research methods are used:

Magnetic resonance imaging is informative if the cause was sclerosis or a tumor.
Angiography - reveals dilated vessels or aneurysms of cerebral vessels that compress the nerve.

Treatment methods for trigeminal neuralgia

The disease is difficult to treat, and if painful attacks last more than a day, the patients are placed in the neurological department of the hospital. There is appointed complex therapy, preventing the development of the chronic form and relieving acute symptoms.

electrophoresis and phonophoresis;
ultrasound treatment;
diadynamic therapy;
acupuncture;
treatment using impulsive low-frequency currents;
laser processing;
exposure to an electromagnet;
infrared and ultraviolet treatment.

If the diagnosis is confirmed, then treatment of nerve inflammation begins with eliminating the underlying pain symptoms. In the future, the causes of the disease are determined (so that the treatment itself is not in vain), tests are prescribed and a full-scale examination of the patient is carried out.

inflammatory processes in the sinuses, if any, are eliminated;
when inflammatory processes are detected in the gums, great attention pay attention to docking them;
if the patient has pulpitis, remove the nerve of the damaged tooth, filling filling material root canals;
If x-rays confirm that a filling is placed incorrectly on one of the teeth, it is re-treated.

To calm the pain, the patient is prescribed necessary complex medications and are referred for an appointment with an endocrinologist, immunologist, infectious disease specialist and allergist. If one of the specialists discovers a problem, they are prescribed appropriate medications.

Video: inflamed trigeminal nerve - how to identify symptoms and cure?

Medicines

You should not resort to self-medication for neuralgia without consulting a doctor who will select necessary drug and its dosage.

Use:

Anticonvulsants: in the form of carbamazepine tablets (in other words - finlepsin, tegretol) - occupies a leading place in this category, providing an analgesic and anticonvulsant effect, inhibiting the activity of neurons, which eliminates pain. Due to its toxicity, it is not recommended for use by pregnant women; it can also lead to mental disorders, toxic damage to the liver and kidneys, drowsiness, nausea, and pancytopenia, among others. It is not recommended to drink during use grapefruit juice, it can worsen the negative effects of the drug on the body. Additionally, valproic acid drugs are prescribed: convulex, depakine, lamotrigine, diphenin (phenytoin), oxcarbazepine.
Painkillers and non-steroidal drugs: Nise, analgin, movalis or baralgin - taken after meals three times a day. The course of treatment is short-lived, since long-term use may cause gastrointestinal problems. They only help at the beginning of an attack. These include: dicloberl, revmoxib, movalis, indomethacin, celebrex.
Painkillers in the form non-narcotic analgesics– in case of severe pain syndrome, dexalgin, ketalgin and narcotic drugs are prescribed: promedol, morphine, tramadol, nalbuphine.
Antiviral drugs - prescribed if neuritis has viral nature. Antibiotics are taken when bacterial nature diseases. The standards are acyclovir, herpevir, lavomax.
Neuroprotectors and vitamin preparations: neurorubin, thiogama, milgama, proserin, nervohel and neurobion relieve nervousness, reducing the risk of an attack.
Glucocorticoids: reduce swelling, inflammation of the nerve, have a strong effect in a short time. Methylprednisolone, hydrocortisone, and dexamethasone are considered the best.

You also need to undergo mandatory physiotherapeutic treatment: paraffin-ozokerite, UHF, electrophoresis, magnetic therapy.

Surgical intervention

Surgical elimination of the cause of neuralgia is used in case of ineffectiveness drug therapy or with prolonged pain.

There are two surgical methods:

microvascular decompression;
radiofrequency destruction;

The first method is trepanation of the posterior part cranial fossa. The trigeminal nerve root, which compresses the blood vessels, is separated. A special gasket is placed between the spine and the vessels to prevent compression to prevent relapses.

The radiofrequency destruction method is not so traumatic and is carried out under local anesthesia; current discharges are directed to the affected area, they also destroy the roots of the trigeminal nerve, which are susceptible to pathological processes.

Sometimes one operation is enough, otherwise the effect is repeated several times.

Massage

Massage at trigeminal neuritis increases tone and relieves excessive muscle tension in certain muscle groups. Improves blood supply and microcirculation in inflamed nerve and in affected superficial tissues.

Impact on reflex zones at the exit points of the facial, auricular and auricular branches of the trigeminal nerve cervical region comes first in massage, after which they work with muscles and skin.

The massage is performed while sitting, leaning your head back on the headrest to relax the neck muscles. Attention is focused on the sternocleidomastoid muscle, thanks to light massaging movements. Then, with stroking and rubbing movements, they move up to the parotid areas, after which they massage the healthy and affected sides of the face.

The procedure lasts about 15 minutes, on average there are 10-14 sessions per course of treatment.

How to treat at home?

The most effective folk remedies and recipes:

chamomile – pour boiling water over 1 tsp. flowers. The drink is taken into the mouth and held there until the pain subsides at least a little;
fir oil – you should rub it into the damaged areas throughout the day. The skin may become red, but the pain will subside. Three days of such procedures are enough;
marshmallow – 4 tsp. the roots of the plant are poured with cooled boiled water, leaving for a day. In the evening, moisten a piece of cloth with the infusion and apply it to the face. The compress is insulated on top with a scarf or parchment paper, removed after an hour and a half, and a scarf is also worn at night;
black radish - wipe the skin with its juice several times a day;
buckwheat - a glass of cereal is well fried in a frying pan, then placed in a bag made of natural fabric, holding it on the affected areas until the buckwheat has cooled. Treatment is repeated 2-3 times a day;
egg - cut a hard-boiled egg in half, applying its parts to the painful areas;
raspberry - a vodka-based tincture is prepared from it by pouring the leaves of the plant (1 part) with vodka (3 parts), after which it is infused for 9 days, then this infusion is consumed for 90 days in a row in small doses before meals;
clay - it is mixed with vinegar, after which thin plates are sculpted, which are applied every evening to the affected area;
dates - several ripe products are ground in a meat grinder, this mass is consumed three times a day, 3 tsp. To improve the taste it is diluted with water or milk;
ice - they wipe the skin of the face with it, covering the neck area, then warm the face, massaging it with warm fingers. At one time, the procedure is repeated for three approaches.

Important! We require that even traditional methods be used only under the supervision of a doctor. He will clarify the prescription and, moreover, will tell you whether treatment with such drugs will be effective specifically in your case.

Consequences

Inflammation of the trigeminal nerve does not involve mortal danger, but the consequences are very dangerous.

Depression is developing rapidly.
Constant pain causes mental disorders, there may be a need to avoid society, and social ties are broken.
The patient loses weight because he cannot eat properly.
The patient's immunity decreases.

Timely elimination of symptoms does not pose a health hazard, and remission, along with conservative treatment, lasting several months, prepares the body for potential surgery.

Video: Fayyad Akhmedovich Farhat (Doctor of Medical Sciences, neurosurgeon of higher qualification category) about a disease of the facial nerve.

Prevention

Since a common cause of inflammation of the trigeminal nerve is any disease of the paranasal sinuses (frontal sinusitis, sinusitis) or dental disease, premature therapy will greatly reduce the risk of the problem occurring.

minimizing psycho-emotional stress;
elimination of possible hypothermia;
avoiding infectious diseases.

For viral and infectious diseases, in parallel with antipyretic and antiviral drugs anticonvulsants should be taken.

Additional questions

What to do if the trigeminal nerve hurts?

If the pain strikes suddenly, you should immediately consult a neurologist, who will determine the source of pain and methods for eliminating pain syndromes, prescribe the necessary medication or refer you to a neurosurgeon. Before going to the doctor, you can try to temporarily calm the pain using traditional methods of treatment.

Which doctor treats you?

A neurologist deals with the treatment of trigeminal neuralgia, and a neurosurgeon deals with surgical intervention on this basis.

ICD-10 code?

In ICD-10 the disease is coded (G50.0).

Does double vision occur?

Double vision with neuralgia is quite real, often accompanied by hearing loss and noise in one of the ears.

Is it possible to heat inflammation of the trigeminal nerve?

The inflamed area should not be heated, even if relief occurs after this. Heat provokes the progression of inflammation, which can spread to other parts of the face.

Is acupuncture effective?

It is believed that acupuncture is really effective for this disease. It affects certain facial points according to special rules and methods.

What should a pregnant woman do with this problem?

You need to see a doctor, he will take appropriate measures. Transcutaneous electrical stimulation, electrophoresis with a sanitary agent, and acupuncture during pregnancy are allowed.

The trigeminal nerve is the fifth pair cranial nerves, provides the main sensory innervation of the face and oral cavity. Many trigeminal nerve fibers terminate in the orofacial tissues as free nerve endings. They are considered nociceptors, as they activate many effects on the body, such as surgical incisions of the skin of the face or oral mucosa, tooth extractions, bacterial toxins (access to unprotected dental pulp), the action of inflammatory mediators, exposure to chemical irritants ( hot peppers, mustard), excessively hot or cold liquids.

These nociceptive afferent fibers conduct nerve impulses to the central nervous system (CNS), providing information about the quality, location, intensity and duration of the stimulus in the brain. Several neurotransmitters are involved in the activation of nociceptors following their release due to tissue damage or inflammation in the innervated area.

Factors, causes of neuralgia

Although exact reasons are not always known, neuralgia is often determined by compression of the trigeminal nerve or as a complication from the underlying disease (in the latter case they speak of inflammation of the trigeminal nerve of a secondary type). Inflammation of the trigeminal nerve may be a consequence normal process aging of the body.

Several groups of neuralgia can be distinguished. Compression of the trigeminal nerve is one of them. Evidence suggests that 80-90% of cases of neuralgia are caused by contact between a nerve and a blood vessel that runs nearby. This arrangement can create pressure on the trigeminal nerve close to the point where it enters the brainstem (the most Bottom part brain, which goes into spinal cord). Repeated compression causes erosion around the nerve (i.e., the myelin sheath), altering the normal conduction of nerve impulses, resulting in inflammation of the trigeminal nerve in the face.

Another group is structural causes that can affect the trigeminal nerve:

anomalies blood vessels(aneurysm);
cysts or tumors;
diseases such as multiple sclerosis, a long-term condition that affects the central nervous system;
complications after herpes infection (Herpes Zoster).

Spontaneous attacks of inflammation of the trigeminal facial nerve can be caused by a wide variety of movements or daily activities. Patients are sensitive in certain areas of the face (trigger zone), which, when stimulated, can cause a painful crisis. These areas are located near the nose, lips, ears, and mouth. Thus, you can prevent painful attacks from occurring by avoiding stimulating these triggers as much as possible. Other activities, such as putting on makeup or brushing your teeth, can trigger trigeminal neuralgia. The pain is caused by exposure to wind on the face or by drinking hot drinks.

Risk factors

The pathology is common among people over 50 years of age, but can also occur at a young age. More common among women.

Additionally, the disorder is congenital, possibly due to heredity in the configuration of blood vessels.

Symptoms of inflammation of the trigeminal nerve

Inflammation of the trigeminal nerve is characterized by sudden cutting pain, sometimes occurs like an electric current that is felt on one side of the jaw or face. The pain may affect both sides of the face, but not at the same time. The attacks, which usually last a few seconds, can be repeated in rapid succession, coming and going throughout the day. These types of episodes can last for days, weeks, or even months, and then disappear for several months or even years. In the days leading up to the attack, some patients may experience a tingling or numb sensation. If you are interested, you can find an image on the Internet with the symptoms of the disease; to do this, enter inflammation of the trigeminal nerve, symptoms and treatment in the photo in a search engine.

Common symptoms of trigeminal nerve inflammation:

tinnitus;
pain in the hands;
pain associated with chewing while eating food;
facial pain;
Pain in the eyes;
tingling in the head;
photophobia;
otalgia (ear pain);
paresthesia;
muscle spasms.

Diagnostics

The diagnosis is usually made by studying the medical history (patient history), symptoms, and includes the following studies:

magnetic resonance imaging, which will determine the presence of a focus of inflammation and indicate its location;
Magnetic resonance angiography will help determine or eliminate the possibility of involvement of the vessels of the face or neck.

Care and treatment

Options for treating trigeminal nerve inflammation include:

medical supplies;
surgical interventions;
complementary approaches.

To treat the symptoms of inflammation of the trigeminal nerve, possible different kinds brain surgeries. The choice of method depends on the patient's preferences, his state of health, any previous interventions, a possible history of multiple sclerosis, and the location of the trigeminal nerve involvement.

If you are still concerned about the question of what inflammation of the trigeminal nerve is and how to treat it, then it is interesting to know that there is such a method as stereotactic radiosurgery. She uses computerized imaging techniques to concentrate beams of radiation in the area where the trigeminal nerve exits brain stem. Patients usually leave the hospital on the day of surgery or the next day.

Among the possible treatment options we have the following techniques and methods:

acupuncture;
vitamin therapy;
in compliance with healthy image life;
electrical stimulation of nerve endings.

Basic methods for treating inflammation at home

Treatment for inflammation of the trigeminal nerve at home is very varied and includes the following:

Bach flowers at inflammatory process and damage to the trigeminal nerve. The psychosomatic component is influenced by Bach flowers. These remedies address the emotional cause or nature of the illness, which causes pain of high intensity and limited duration, promoting the healing process in a gentle, natural manner.
Aromatherapy for neuralgia. Essential oils with anti-inflammatory and analgesic effects on nerve tissue are useful for the treatment of neuralgia. They are used for external use, carried out using vegetable oil or neutral cream (3-5 drops), with gentle massaging on the affected area until completely absorbed. It is necessary to repeat the procedure several times a day.
Essential camphor oil has an analgesic and anti-inflammatory effect, helps relieve dislocations, bruises, pain, sprains, and neuralgia.
Clove essential oil has an anti-inflammatory and analgesic effect, used to relieve headaches, neuralgia, and toothache.
St. John's wort is used to calm the nerves and help depression. Do not take in combination with antidepressants.
Jamaican dogwood tincture for pain and neuralgia.
Red poppy is a mild pain relief.
Celery essential oil relieves pain and has an anti-inflammatory effect in neuralgia and rheumatic pain.
Exercises. These include spinal traction, and relaxation of the muscles of the back and face.

Diagnosis and treatment of inflammation of the trigeminal nerve was last modified: May 6th, 2016 by MaximB

My mother has inflammation of the trigeminal nerve right jaw. Suffers from constant pain for 2 years now. Doctors prescribed treatment, but it did not help. We also contacted other specialists, but to no avail. Perhaps you can recommend some effective method? Sincerely, Bogdan Nikolaevich. Lviv region

MAIN SYMPTOM—SEVERE PAIN

Trigeminal neuralgia looks completely different from facial neuralgia. It is characterized by attacks of severe pain in the cheek, jaw, head, possibly lacrimation and drooling. In this case, there are no changes in the facial muscles. Trigeminal neuralgia can occur due to hypothermia or injury, but most often appears for no apparent reason. Academic medicine uses anticonvulsants, anti-inflammatory and hormonal drugs. If inflammation of the facial nerve occurs at any age, then damage to the trigeminal nerve is usually found in middle-aged and elderly people. The trigeminal nerve controls the sensitivity of the skin and mucous membranes of the face, including the eyes, nose, gums, as well as the teeth of the upper and lower jaws, and tongue. It has three branches, hence the name "trigeminal". These branches exit the skull through a narrow opening, so even a slight narrowing of these openings compresses the branches of the nerve, and signs of the disease appear. Trigeminal neuralgia is a painful, often chronic and difficult to treat disease. The main symptom is pain. This pain is burning, drilling, piercing. It usually starts from one point - the temple, the edge of the nose, the corner of the mouth, a tooth and then spreads to some part or the entire half of the face. The attack of pain is usually short-lived, but very intense. At the time of an attack, the patient freezes with a grimace on his face or rubs the sore spot with his hand or towel; the face often turns red, and there may be lacrimation. The attacks usually follow each other almost without interruption. If the second or third branches of the trigeminal nerve are affected, the pain usually affects the teeth. And very often, such patients first turn not to a neurologist, but to a dentist, insist on having their teeth removed, and often, since the pain does not disappear, they convince the dentist to remove one tooth after another, although there is no need for this. Seizures are provoked by the most various factors: noise, talking, eating, shaving. Therefore, such patients are often afraid to eat, do not shave, are reluctant to talk, and withdraw into seclusion. With trigeminal neuralgia, periods of improvement or disappearance of pain are followed by periods of exacerbation. The pain is paroxysmal in nature, in one half of the face. The duration of such pain is from several seconds to 2 minutes, but no more. These pains feel like a blow electric shock. During an attack, the patient freezes in a pained grimace. The localization of pain is limited to the areas of the branches of the trigeminal nerve. Trigeminal neuralgia is characterized by the presence of points (oral mucosa, around the lips and wings of the nose), irritation of which provokes an attack. But immediately after a painful attack there is a pain-free period lasting up to several minutes.

PHYTOCOMPRESSES AND... HOT BUCKWHEAT WILL HELP

The challenge is to reduce pain syndrome, prolong the state of improvement, prevent exacerbations. Trigeminal neuralgia is treated by neurologists, physiotherapists, and in some cases neurosurgeons. Unfortunately, it is not always effective. Most effective means, relieving pain, in official medicine are blockades and treatment with alkaloid drugs of the branches of the trigeminal nerve. For inflammation of the trigeminal nerve, you can first use a simple folk remedy that brings relief. Prepare a cold infusion: 4 tsp. marshmallow roots per glass boiled water room temperature, leave for at least eight hours. This is done at night. In the morning, brew chamomile tea: a teaspoon per glass of boiling water, leave in a warm place for half an hour, strain. Take a mouthful of this chamomile tea and hold it as long as possible near the sore cheek. A compress of several layers of gauze soaked in marshmallow infusion is applied externally. Tie a warm scarf or handkerchief over the plastic film. After the compress, warmth is also necessary. The procedure is repeated several times a day. If there is no marshmallow root, they can replace it collected in summer its flowers and leaves. They put 2 tbsp. l. per glass of boiling water. After an hour, the infusion is ready for use. Before going to bed, make a compress with marshmallow infusion. You can cook it like this: 4 tsp. pour a glass of water at room temperature over the roots and leave for at least eight hours. Then apply several layers of gauze soaked in warm marshmallow infusion to the sore cheek. Place wax paper on top, then tie with a warm scarf. Keep the compress for an hour and a half. After the bandage is removed, wrap your head in a scarf and go to bed. So treat while there is pain. At the same time you need to apply similar procedures with ordinary geranium, which grows on many people’s windowsills. To do this, you can simply wrap freshly picked leaves in a piece of clean cloth, apply it to the problem area and tie something warm on top, such as a down scarf. There is no need to wash or pre-treat the leaves in any way. The pain will stop bothering you in a couple of hours. Such procedures should be repeated for several days 2-3 times a day. When treating the trigeminal nerve, you should also take chamomile. Take 1 liter of boiled water, add 5 tbsp. l. dry chamomile. Leave for 2 hours and drink a quarter glass after meals. It’s good if black currant leaves are prepared. Then take 4 tbsp. l. currant leaves, grate the zest of 1.5 lemons, 3 tbsp. l. lemon balm. Mix, pour 500 ml of boiling water. Leave for 6 hours, drink 100 ml tincture 0.5 hour before meals. Rubbing and applying helps. For example, tincture of golden mustache, if rubbed into painful places. To prepare it, you need to take 20 joints of the plant, grind them in a mortar and leave in a warm, dark place in 0.5 liters of vodka for 10 days. The finished tincture is filtered through cheesecloth and stored in the refrigerator. Also, apply golden mustache leaves scalded with boiling water to painful areas three times a day for 10 minutes. I want to bring old recipe from home remedies. You need to heat a glass of buckwheat in a frying pan, pour it into a cotton bag and apply it to the sore spot, hold until the cereal has cooled. Do this procedure three times a day. If you include in your daily menu Bell pepper with a strong infusion of chamomile, there is a high probability that your condition will also improve.

MASSAGE IS APPLIED VERY CAREFULLY

An essential addition to the complex treatment of facial pain syndrome is massage. In this case, massage is used when acute phenomena subside, between courses of other physiotherapeutic procedures, with quite great effectiveness. In the presence of skin hyperesthesia, massage of the face and neck is contraindicated. It should be recognized that the effectiveness of massage for trigeminal neuralgia is limited. Required condition Its application in the neck and face is to begin the massage procedure from distant areas (sacrum and others) to prevent negative reactions. The course of treatment requires from twelve to fifteen procedures, the time of the first procedures is 20-25, and the subsequent ones are 45-60 minutes. Repeated courses are possible no earlier than after 2 months. If there is no hyperesthesia of the skin of the face and neck, then facial massage is possible. But it is carried out with extreme caution. All massage movements are first performed on the healthy half of the face, and then on the patient. However, you can’t rely on constant help from a massage therapist. Therefore, I want to give an example of self-massage of the face. It is performed first on the healthy side and then on the diseased side. The tips of the middle and ring finger placed 1-2 centimeters below the cheekbone. A series of short movements are performed underneath it to the external auditory canal. Long movements are performed along the same line and in the same direction, which have a pronounced relaxing effect. They are repeated several times. Then, from the external auditory canal up along the border of the scalp, long movements are carried out to the upper edge of the temple. From the middle of the front border of the scalp to the upper edge of the temple, short and then long movements are performed, repeated 3-5 times. From the inner end of the eyebrow to the outer end, departing from the brow ridge by 1-2 cm, make short movements. Short movements are carried out from top to bottom (towards the eyebrow). The massage of the superciliary arches is closely adjacent to the lines in the temporal region, which are turned on as needed. The direction of movement is from the outer corner of the eye obliquely upward to the scalp. In the temporal region, it is possible to carry out 3-4 semi-long movements with the middle and ring fingers of the hand of the same name, while the free hand fixes soft fabrics at the outer corner of the eye. Indications for including the forehead area in the massage procedure are headaches accompanied by insomnia, irritability, anxiety, and fear.

HOMEOPATHY WILL IMPROVE THE HEALING EFFECTS

For complex treatment of facial neuritis and trigeminal neuralgia, I recommend treatment medicinal plants combine with a well-proven complex of herbal homeopathic therapy. At correct selection With a constitutional remedy, you can achieve not only a lasting analgesic effect, but also a complete recovery. The use of homeopathic medicines as symptomatic treatment, when the clinical picture of the disease corresponds to the symptoms of the drug, helps to significantly increase the effectiveness of basic therapy. Homeopathic medicines should be combined with the above herbal medicine treatment methods. One of the main remedies in the treatment of trigeminal neuralgia is Spigelia. Especially with sudden, stabbing “dagger” pain. With severe, excruciating pain in the eyeballs and around the eyes, spreading deep into the eye socket. A decoction of mountain arnica helps relieve pain. Take a decoction of 0.5 cups 3-4 times a day and during an attack. You can also take it every 10 minutes homeopathic medicine Arnica. Argentum nitricum, Gelsemium, Lycopodium and Rhus toxicodendron will also help; they can be taken every three hours until the drug suitable for a particular case is selected. The main treatment is taking 2 times a week for 1.5 months such drugs as Agaricus 30 - daily in the morning, Spigelia 200 - daily in the afternoon, Xanthoxylum 30 - daily in the evening. These drugs are used according to instructions. Additionally used for trigeminal neuralgia with burning, shooting pain and numbness, as if a stream of cold air is blowing into the eye, Mezereum (meserium) and Verbascum (verbascum). It has a pronounced effect on the lower branch of the trigeminal nerve, on the ear, and on the respiratory organs. When there is pain in the cheekbone, temporomandibular joint and ear, especially on the left, with lacrimation, runny nose and a feeling as if the affected parts are being squeezed by pincers, when talking, sneezing, changes in air temperature and clenching the teeth increase the pain. Combine herbal medicine and herbal homeopathy with lecithin (1000 mg with each meal), B complex vitamins, folic acid(400 mg) and separately vitamin B1, all within a week. Take double the daily dose twice a day multivitamin complex group B. Chromium can be taken with food three times a day (in divided portions at the rate of 40 mg per 30 cm of height). Regular oat extract is taken in liquid form - 1 tsp. liquid oat extract, diluted with water, every three hours. With any neurological symptoms that do not disappear for a long time, or in case of obvious serious nerve injury, you should consult a neurologist. If large nerves are affected, you should apply special methods examinations, such as nerve conduction tests and optical magnetic resonance imaging. Believe that the combination of herbal medicine, homeopathy, massage will bring significant relief and pain will subside! The patient must believe that even before the end of 1.5 months the pain will lose its acute nature, the twitching of the facial muscles will disappear, and the activity of the heart will normalize. Acupuncture and acupressure techniques can quickly relieve pain and promote healing. Specific techniques You can study the ones that are right for you by contacting an acupuncturist or shiatsu specialist, or by reading books on acupuncture.

DIET AND REST - COMPONENTS OF SUCCESS

Long-term care chronic cases Trigeminal neuralgia must be special. In all cases, you must follow a dietary regime. Some cases require a year or two to overcome the toxic condition as the cause of the disease and exposure to pain, which often persists even after the cause has been eliminated. It is necessary to include and apply willpower to overcome, endure, ignore and minimize painful, painful consciousness. Quite a long fast or even several fasts are absolutely necessary for the treatment. You should avoid all carbohydrates for several months. Sweets, seasonings, stimulants of all kinds should be completely excluded. The diet should be non-irritating to avoid reflex stimulation of the sensitive gastric and intestinal mucous membranes. It is necessary to give food consisting of all the necessary basic organic salts and vitamins in proper combinations. It is necessary to raise the level of the patient’s physical and mental state, and carefully guide and inspire him.

SYMPTOMS OF INFLAMMATION OF THE TRIGEMINAL NERVE

Of course, it is necessary to stop drinking alcohol and medications that cause innervation and disturbances in the body. Along with alcohol, you should give up tobacco and coffee. It is necessary to correct all innervating causes and addictions. And until the acute symptoms go away, you need absolute rest. The cause must be eliminated - the factor must be done away with toxic irritation, i.e. First of all, you need to eliminate toxemia. Fasting gives quick results in removing toxins. In chronic cases, rest and fasting are equally valuable. After symptoms disappear - physical exercise(where necessary - passive, where possible and when possible - active) plus proper food and sunbathing will also promote health, which neither massage nor treatment can ever do. For example, in acute stage Sunbathing is beneficial for neuritis; care must be taken not to cause overheating, which increases the pain.

AND A LITTLE MORE ABOUT PAIN RELIEF

Be careful about the side effects that classic painkillers have. However, classic mild medications such as aspirin, paracetamol or acetaminophen can be taken for pain relief if there are no individual contraindications due to the side effects of these drugs. To relieve long-term pain, you can take vitamin B1 (10 mg per 30 cm of height, 3 times a day with meals, for the first three days, and then only once a day). These recommended doses should be taken in portions throughout the day. Pain is a subjective sensation, so methods such as relaxation, biological Feedback, hypnosis may well help. Willow and meadowsweet also contain salicylic acid (aspirin). You definitely need to know the right ways preparing painkillers from them and correct reception. And these are individual doses. In this case, I am always ready to advise and help. Remember also that when it is possible to achieve significant improvements in a short time, then repeat courses, including electro- and mud therapy, acupuncture, therapeutic exercises.

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 motor function 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 at the point where it exits the skull bridge can be compressed by various pathological formations. There are several reasons for this compression:

Vascular diseases leading to nerve compression: aneurysms (pathological changes in blood vessels), atherosclerosis (thickening 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 past 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.

Nervous system diseases: some pathologies, for example, multiple sclerosis, cerebral palsy, 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 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.

Pathology of conduction causes a violation of the inhibition of nerve impulses, as a result of which the nuclei of the trigeminal nerve (located in the midbrain and hindbrain) are overstimulated. 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 occur in different facial areas. In case of defeat:

I branch – in the region upper eyelid, eyeball, inner corner eyes, 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 food, 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... blood and lymph circulation in the affected area is impaired, 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 pain attacks, constant fear 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 painful attacks with periods of prosperity;
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 a 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 they may remain persistent side effects, for example, a change 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 a 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.

Commonly used to relieve pain from trigeminal neuralgia. medications. comes down to taking antispasmodics, muscle relaxants and anticonvulsants.