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

Neurologist UZ 10 GKB
Kalupina I.G.

Trigeminal neuralgia is pressure, irritation, or inflammation of the trigeminal nerve. The disease causes severe pain in the face. More than a million people worldwide 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 the destruction of the nerve sheath. 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 a severe blow to the face.

Causes of trigeminal neuralgia

There are the following causes of trigeminal neuralgia:

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

An attack of trigeminal neuralgia can occur when a person is washing, shaving, brushing their teeth, talking, or smiling. 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 region of 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, after hypothermia.

Pain in trigeminal neuralgia is typical and atypical.

Typical pain has a cyclical nature: it intensifies, then subsides. Shooting pain, similar to an electric shock, begins with touching a certain area of the face. Painful sensations are 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.

Atypical pain is less common and is felt constantly. It covers more of the face than typical pain. With this form of the disease, the pain may not subside. Such neuralgia is more difficult to treat.

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

Why is inflammation of the trigeminal nerve dangerous?

Without proper treatment, the disease leads to serious complications:

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

Due to frequent bouts of pain, a person develops depression, he cannot eat normally, loses weight, his immunity drops. Constant pain can disturb the psyche, the patient avoids communication.

Treatment of trigeminal neuralgia

Among the methods of treatment of trigeminal neuralgia, both conservative measures and radical methods, in particular, surgical intervention, as well as minimally invasive procedures, are used.

Conservative treatment consists in prescribing various medications and physiotherapy methods. Usually, drug treatment is very effective. But, as the disease progresses, drug therapy becomes ineffective or ceases to stop pain attacks altogether. In addition, any drug therapy is characterized by the 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 of drugs are used, among which are such as:

Anticonvulsants. Most often, among anticonvulsants, carbamazepine is used - a very popular and effective remedy for relieving pain attacks associated with trigeminal neuralgia. In addition to it, other drugs of 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 a different drug. Therapy with anticonvulsants can also lead to side effects, including dizziness, drowsiness, blurred vision (double vision), and nausea.

Antispasmodics and muscle relaxants. These drugs are usually used in combination with anticonvulsants. Baclofen is most commonly used in combination with carbamazepine or phenytoin. They can also be administered in isolation.

Alcohol blockade of the trigeminal nerve

Alcohol blockade of the trigeminal nerve leads to the so-called. freezing of the affected area of the face, which is accompanied by a pronounced analgesic effect. Such an injection of ethanol is carried out in the area of \u200b\u200bpassage of one of the branches of the trigeminal nerve, which is affected. The effect of such injections is short-lived, and the pain inevitably recurs in the future, 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 do a second injection.

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. An injection of ethyl alcohol is carried out by its intraneural injection in an amount of 1-2 ml. Usually 80% alcohol solution is used in combination with novocaine. At the same time, 1-2 ml of 2% novocaine is first injected, and then, after achieving conduction anesthesia, alcohol. This procedure is most often performed on an outpatient basis, but requires the doctor to have special skill and experience in conducting such injections.

Surgical treatment of trigeminal neuralgia

In the surgical treatment of trigeminal neuralgia, the doctor tries to eliminate the compression of the nerve trunk by the blood vessel. In other cases, the destruction of the trigeminal nerve itself or its node is carried out in order to relieve pain. Surgical treatments for trigeminal neuralgia are often minimally invasive. In addition, the surgical method also includes the so-called. radiosurgery is a bloodless intervention that does not require incisions or sutures.

Prevention

treat teeth, sinusitis, sinusitis, acute infections in time;
eat more fresh fruits and vegetables to strengthen immunity;
temper;
avoid drafts, hypothermia, stress, injury, intoxication;
go in for sports: swimming, dancing, running;
avoid drafts, hypothermia, stress;
limit alcohol consumption, do not smoke.

Physiotherapy

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

Perform smooth head rotations for 2 minutes, first clockwise, then counterclockwise.
Pull the head and neck first to the right shoulder, then to the left. Repeat tilts 4 times to each shoulder.
Stretch your lips in a smile, then gather them into a “tube”. Repeat the exercise 6 times.
Draw air into your cheeks and exhale it through a narrow gap in your lips. Repeat 4 times.
Make a "fish": draw 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 - pain symptoms overtake the victim suddenly and you have to go a long way to get rid of them.

Description

So what is neuralgia and what is the problem 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 character, the consequences of which can be seen literally “on the face”. With a lesion, pain appears in the forehead, nose, superciliary arches, jaw, neck and chin. Severe attacks of toothache are possible. In parallel, there is a nervous twitching, blanching or redness of the skin, including atrophy of the facial muscles.

The disease occurs for various reasons - it can be independent or a consequence of various infections, overwork and stress. Having noticed the signs of neuralgia, you should not postpone the appointment with the doctor and start treatment as soon as possible.

Types of inflammation

Since each part of the trigeminal nerve divides into smaller branches that lead to all areas on 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 chewing muscles and the lower jaw.

There are two types of disease:

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

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

The reasons

Doctors still cannot 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 - it can be internal and external. It is customary to refer to internal tumors and adhesions formed after injuries, as well as a shift in the location of arteries and veins near the trigeminal nerve. Inflammations in the oral cavity and nasal sinuses are attributed to external factors;
hypothermia of the face area - occurs among those who do not prefer to wear a hat in winter. If the nerve is stiff, an attack of neuralgia can provoke even washing with cold water;
signs of an immune ailment of the body, against which herpes has become more active - in this case, anti-herpes drugs help;
diseases of the oral region - an additional impetus for neuralgia: periodontitis, gingivitis, gum abscess, periodontitis and other types of caries complications, including very dangerous. If the filling is placed incorrectly (the material goes beyond the border of the top of the tooth) or the patient was injured during the extraction of the tooth, this can also be the cause;
shingles - a disease that is viral in nature and activates if the body is weakened, as a result of reproduction, it develops an inflammatory process of the trigeminal nerve;
"Hunger" of the nerve - the accumulation of cholesterol plaques on the walls of blood vessels.

To get rid of inflammation, it is worth doing treatment:

some forms of allergies;
disorders of the endocrine system;
metabolic failure;
depression and insomnia;
neurosis;
cerebrovascular diseases;
psychogenic disorders;
multiple sclerosis;
hyperinfection;
lowered immune system.

The etiology of neuralgia is indeed wide, but it is generally accepted that it usually occurs in women aged 45 to 70 years. With age, immunity decreases and any physical activity can cause an attack of the disease.

Video: trigeminal neuralgia in the program “Live Healthy” 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 inflammation developed earlier - a stressful situation triggered a trigger for the appearance of pain.

Branching of the trigeminal nerve affects the motor and sensory fibers, there is acute pain, spasms in the chewing muscles, all these symptoms indicate inflammation.

Symptoms of damage to the facial nerve are as follows:

sharp penetrating pain in one of the halves of the face, which has a through character;
distorted facial expressions due to the distortion of certain areas or in the area of \u200b\u200bone of the halves of the face;
headaches, chills, general weakness, muscle pain throughout the body;
an increase in body temperature (hyperthermic reaction of the body);
with severe pain syndrome - insomnia, fatigue and irritability;
muscle twitching near the affected nerve;
a small rash at the site of the lesion 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 for life if the disease becomes protracted or progressive.

With prolonged existence of the disease, pallor or redness of the skin, changes in the secretion of glands, greasiness or dryness of the skin, swelling of the face, and even loss of eyelashes are possible.

Pain in neuralgia is divided into two types:

Typical pain is sharp and intense, intermittent, and may fade and reappear. With neuritis, a 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, aching pain comes in return.
Typical pain can be provoked by washing, brushing teeth, shaving, applying makeup - actions that affect one of the parts of the face. Pain occurs during laughter, smiling and talking, most often occurs after exposure to low temperatures on one of the halves of the facial and ear areas.
Atypical pain - constant with short breaks, captures most of the face, because of this, it is difficult for the patient to determine its source. It happens that a pain attack is accompanied by muscle spasm, then a painful tick occurs on the affected side of the face. Their sudden contraction looks like an 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, as the pain torments the patient every hour, reaching its peak in 20 seconds, after which it continues for some time.

Anatomy scheme, photo

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

Up - frontal and eye part.
Lower jaw.
upper jaw

In the first two branches, the fibers are sensitive, in the last - sensitive and chewing, providing active muscle movements of the jaw.

Diagnostics

In the diagnosis of pathology, it is important to consult a doctor in time for an assessment of the pain syndrome and a neurological examination. The diagnosis is based on the patient's complaints, the specialist determines the type of pain syndrome, its triggers, localization and possible injury sites that cause a pain attack.

To determine the area of the lesion and find out which of the branches 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.

Methods of treatment of trigeminal neuralgia

The disease is difficult to treat, and if the pain attacks last more than a day, then the patients are placed in the neurological department of the hospital. There, complex therapy is prescribed to prevent the development of the chronic form and relieve acute symptoms.

electrophoresis and phonophoresis;
ultrasound treatment;
diadynamic therapy;
acupuncture;
treatment with impulsive low-frequency currents;
laser processing;
electromagnet influence;
infrared and ultraviolet treatment.

If the diagnosis is confirmed, then the treatment of nerve inflammation begins with the elimination of the main 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 in the gums are detected, much attention is paid to their relief;
if the patient has pulpitis, the nerve of the damaged tooth is removed, filling the root canals with filling material;
if the x-ray confirms that one of the teeth has an incorrect filling, it is retreated.

To soothe the pain, the patient is prescribed the necessary set of drugs and referred to an appointment with an endocrinologist, immunologist, infectious disease specialist and allergist. If one of the specialists detects a problem, he is prescribed appropriate medications.

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

Medicines

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

Use:

Anticonvulsants: in the form of carbamazepine tablets (in other words, finlepsin, tegretol) - occupies a leading position in this category, providing analgesic and anticonvulsant effects, inhibits neuronal activity, 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, including pancytopenia. During the reception, it is not recommended to drink grapefruit juice, it can aggravate the negative effects of the drug on the body. Additionally, valproic acid preparations are prescribed: convulex, depakine, lamotrigine, difenin (phenytoin), oxcarbazepine.
Painkillers and nonsteroidal drugs: nise, analgin, movalis or baralgin - are taken after meals three times a day. The course of treatment is short, as long-term use can cause problems with the gastrointestinal tract. Help only at the beginning of the attack. These include: dicloberl, revmoksib, movalis, indomethacin, celebrex.
Painkillers in the form of non-narcotic analgesics - in the case of a severe pain syndrome, dexalgin, ketalgin and narcotic drugs are prescribed: promedol, morphine, tramadol, nalbuphine.
Antiviral agents - are prescribed if neuritis is of a viral nature. Antibiotics are drunk with the bacterial nature of the disease. The standards are acyclovir, herpevir, lavomax.
Neuroprotectors and vitamin preparations: neurorubin, thiogama, milgama, prozerin, nervochel and neurobion relieve nervousness, reducing the risk of an attack.
Glucocorticoids: reduce swelling and inflammation of the nerve, have a strong effect in a short time. The best are methylprednisolone, hydrocortisone, dexamethasone.

You also need to undergo mandatory physiotherapy: paraffin-ozocerite, UHF, electrophoresis, magnetotherapy.

Surgical intervention

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

There are two surgical methods:

microvascular decompression;
radiofrequency destruction;

The first method is trepanation of the back of the cranial fossa. The root of the trigeminal nerve is separated, squeezing the vessels. A special gasket is placed between the root and the vessels, which prevents squeezing, to prevent relapses.

The method of radiofrequency destruction 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 subject to pathological processes.

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

Massage

Massage with trigeminal neuritis improves tone and relieves excessive muscle tension in certain muscle groups. Blood supply and microcirculation in the inflamed nerve and in the affected superficial tissues improve.

The impact on the reflex zones at the exit points of the branches of the trigeminal nerve of the facial, ear and neck areas is in the first place in the massage, after which they work with the muscles and skin.

Massage is carried out while sitting, leaning back the head on the headrest to relax the muscles of the neck. Attention is focused on the sternocleidomastoid muscle, thanks to light massaging movements. Then, with stroking and rubbing movements, they rise 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 treatment course.

How to treat at home?

The most effective folk remedies and recipes:

chamomile - pour 1 tsp with boiling water. flowers. The drink is taken into the mouth and kept there until the pain recedes a little;
fir oil - it should be rubbed into the damaged areas throughout the day. Redness may appear on the skin, but the pain will recede. 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, a piece of cloth is moistened with infusion, applied to the face. The compress is insulated from above with a scarf or parchment paper, removed after an hour and a half, and a scarf is also put on at night;
black radish - rub the skin several times a day with its juice;
buckwheat - a glass of cereal is well fried in a pan, then placed in a bag made of natural fabric, holding it on diseased areas until the buckwheat cools down. The treatment is repeated 2-3 times a day;
egg - cut a hard-boiled egg in half, applying its parts to the places affected by pain;
raspberries - a tincture based on vodka is prepared from it, 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 kneaded with vinegar, after which thin plates are molded, 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 for 3 tsp. To improve the taste, it is diluted with water or milk;
ice - they wipe the skin of the face, capturing the neck area, after which the face is warmed up, massaging it with warm fingers. At one time, the procedure is repeated for three approaches.

Important! Even folk methods are required to be used only under the supervision of a doctor. He will clarify the prescription and, moreover, will tell you whether the treatment with such means will be effective in your particular case.

Effects

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

Intensively developing depression.
Constant pain causes mental disorders, there may be a need to avoid society, social ties are torn.
The patient loses weight because he cannot fully eat.
The patient's immunity is reduced.

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

Video: Fayyad Akhmedovich Farhat (doctor of medical sciences, neurosurgeon of the highest qualification category) about the 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 a problem.

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

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

Additional questions

What to do if the trigeminal nerve hurts?

If the pain struck suddenly, you should immediately contact a neurologist who will determine the pain focus 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 soothe the pain with the help of alternative methods of treatment.

What doctor treats?

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

Code under ICD-10?

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

Does doubling occur?

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

Is it possible to warm the inflammation of the trigeminal nerve?

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

Is acupuncture effective?

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

What should a pregnant woman do about this problem?

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

The trigeminal nerve is the fifth pair of cranial nerves and provides the main sensory innervation of the face and oral cavity. Many fibers of the trigeminal nerve 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 in the skin of the face or oral mucosa, extractions of teeth, bacterial toxins (access to unprotected dental pulp), the action of inflammatory mediators, exposure to chemical irritants (hot pepper, mustard), excessively hot or cold liquids.

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

Factors, causes of neuralgia

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

Several groups of neuralgia can be distinguished. Trigeminal nerve compression 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 put pressure on the trigeminal nerve close to the point where it enters the brainstem (the lowest part of the brain that continues into the spinal cord). Repeated compressions cause erosion around the nerve (i.e., the myelin sheath), changing the normal conduction of nerve impulses, resulting in inflammation of the trigeminal nerve on the face.

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

blood vessel abnormalities (aneurysms);
cysts or tumors;
diseases such as multiple sclerosis, a long-term condition that affects the central nervous system;
complications after herpetic 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, mouth. Thus, you can prevent the occurrence of painful attacks by avoiding, as far as possible, the stimulation of these triggers. Other activities, such as doing makeup or brushing your teeth, can trigger trigeminal neuralgia. The pain is caused by exposure to the wind or hot drinks.

Risk factors

Pathology is common among people over 50 years old, but can also occur at a young age. More common among women.

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

Symptoms of inflammation of the trigeminal nerve

Inflammation of the trigeminal nerve is characterized by a sudden cutting pain, sometimes like an electric current, which is felt on one side of the jaw or face. The pain can cover both sides of the face, but not at the same time. The attacks, which usually last a few seconds, can come and go in quick succession throughout the day. Episodes of this kind 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 sensation of tingling, numbness. If you are interested, you can find an image on the Internet with the symptoms of the disease, for this, enter in the search engine inflammation of the trigeminal nerve, symptoms and treatment in the photo.

Common symptoms of trigeminal inflammation include:

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

Diagnostics

Diagnosis is usually made by studying the history of the disease (patient's medical history), symptoms, and includes such studies:

magnetic resonance imaging, which will determine the presence of a focus of inflammation, indicate its localization;
magnetic resonance angiography will help to find out or remove the possibility of involving the vessels of the face or neck in the process.

Care and treatment

Options for treating trigeminal inflammation include:

medical preparations;
surgical interventions;
complementary approaches.

Various types of brain surgery are possible to treat the symptoms of trigeminal inflammation. The choice of method depends on the preferences of the patient, his state of health, any previous interventions, the possible presence of multiple sclerosis in history, the location of the involvement of the trigeminal nerve.

If you are still concerned about the question of what trigeminal inflammation is, 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 focus beams of radiation on the area where the trigeminal nerve emerges from the 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;
with a healthy lifestyle;
electrical stimulation of nerve endings.

The main methods of treating inflammation at home

Treatment of trigeminal inflammation at home is very diverse and includes the following:

Bach flowers in the inflammatory process and damage to the trigeminal nerve. The psychosomatic component is influenced by the Bach colors. These remedies work on the emotional cause or nature of the disease, which causes pain of high intensity and limited duration, and promotes the healing process in a gentle, natural way.
Aromatherapy for neuralgia. Essential oils with anti-inflammatory and analgesic effects on nerve tissues are useful for the treatment of neuralgia. They are used for external use, carried out with 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 to relieve dislocations, bruises, pain, sprains, and neuralgia.
Essential oil of clove - anti-inflammatory and analgesic effect, used to relieve headaches, neuralgia, 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 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 trigeminal inflammation in her right jaw. Suffering from constant pain for the past 2 years. Doctors prescribed medication, but it did not help. Appealed to other specialists, but to no avail. Can you recommend any effective method? Sincerely, Bogdan Nikolaevich. Lviv region

MAIN SYMPTOM IS STRONG PAIN

Trigeminal neuralgia looks completely different from facial neuralgia. It is characterized by bouts of severe pain in the cheeks, jaws, head, possibly lacrimation and salivation. At the same time, there are no changes in the facial muscles of the face. Trigeminal neuralgia can occur due to hypothermia, trauma, but most often appears for no apparent reason. Academic medicine uses anticonvulsant, anti-inflammatory and hormonal drugs to treat problems of the facial and trigeminal nerves. If inflammation of the facial nerve occurs at any age, then the defeat of the trigeminal nerve is usually in the middle and elderly. 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 the 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, boring, penetrating. It usually starts from one point - the temple, the edge of the nose, the corner of the mouth, the 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 the attack, the patient freezes with a grimace on his face or rubs the sore spot with his hand, towel, the face often turns red, there may be lacrimation. Attacks usually follow each other almost without interruption. If the second or third branch of the trigeminal nerve is affected, the pain usually traverses the teeth. And very often such patients first turn not to a neuropathologist, but to a dentist, insist on the extraction of teeth and often, since the pain does not disappear, they convince the dentist to remove one tooth after another, although this is not necessary. Attacks are provoked by a variety of factors: noise, talking, eating, shaving. Therefore, often such patients are afraid to eat, do not shave, are reluctant to talk, retire. With trigeminal neuralgia, periods of improvement or disappearance of pain are replaced by periods of exacerbation. The pains are paroxysmal in nature, in one half of the face. The duration of such pain is from a few seconds to 2 minutes, but no more. These pains are like an electric shock. During an attack, the patient freezes in a suffering grimace. Localization of pain is limited to the areas of the branches of the trigeminal nerve. Trigeminal neuralgia is characterized by the presence of points (the mucous membrane of the mouth, around the lips and wings of the nose), the irritation of which provokes an attack. But immediately after the pain attack, there is a pain-free period lasting up to several minutes.

PHYTOCOMPRESSES AND... HOT BUCKWHEAT WILL HELP

The task is to reduce the pain syndrome, prolong the state of improvement, and prevent exacerbations. Trigeminal neuralgia is treated by neurologists, physiotherapists, and in some cases neurosurgeons. Unfortunately, it is not always effective. The most effective pain relievers in official medicine are blockades and treatment with alkaloid preparations of the branches of the trigeminal nerve. With inflammation of the trigeminal nerve, you can first use a simple folk remedy that brings relief. Preparing a cold infusion: 4 tsp. marshmallow roots in a glass of boiled water at room temperature, leave for at least eight hours. This is done at night. In the morning, brew tea from medicinal chamomile: a teaspoon in a glass of boiling water, soak in a warm place for half an hour, strain. Take a mouthful of this chamomile tea and hold as long as possible near the sore cheek. Outside, a compress is applied from several layers of gauze soaked in an altein infusion. Tie a warm scarf or scarf over the plastic wrap. After the compress, you also need warmth. The procedure is repeated several times a day. If there is no marshmallow root, its flowers and leaves collected in summer can be replaced. They put 2 tbsp. l. to a glass of boiling water. An hour later, the infusion is ready for use. Before going to bed, make a compress with Althea infusion. You can cook like this: 4 tsp. roots pour a glass of water at room temperature, leave for at least eight hours. Then apply several layers of gauze soaked in warm Altai infusion on the sore cheek. On top - wax paper, then tie with a warm scarf. Keep the compress for an hour and a half. After the bandage is removed, wrap your head with a scarf and go to bed. So be treated while there is pain. At the same time, it is necessary to apply similar procedures with ordinary geraniums, which grow on many windowsills. For this, you can simply wrap the freshly picked leaves in a piece of clean cloth, attach to the problem area and tie something warm over it, such as a downy scarf. Leaves do not need to be washed or pretreated in any way. The pain will stop bothering you after a couple of hours. Such procedures should be repeated for several days 2-3 times a day. In the treatment of the trigeminal nerve, one should also take chamomile. Take 1 liter of boiled water, pour 5 tbsp. l. dry chamomile. Infuse for 2 hours and drink a quarter cup after meals. It is good if blackcurrant leaves are harvested. 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. Infuse for 6 hours, drink tincture of 100 ml 0.5 hours before meals. Rubbing and applying help. For example, tincture of a 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 infuse in a warm, dark place in 0.5 liters of vodka for 10 days. The finished tincture is filtered through gauze and stored in the refrigerator. Also, three times a day for 10 minutes, apply golden mustache leaves scalded with boiling water to painful places. I want to bring an old recipe from home remedies. You need to heat a glass of buckwheat in a frying pan, pour it into a bag of cotton fabric and attach it to a sore spot, hold it until the groats cool down. Do these procedures three times a day. If you include capsicum with a strong infusion of chamomile in your daily menu, then it is likely that your condition will also improve.

MASSAGE IS USED 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 a fairly high efficiency. In the presence of skin hyperesthesia, massage of the face and neck is contraindicated. It should be recognized that the effectiveness of massage in trigeminal neuralgia is limited. A prerequisite for its use in the neck and face is the beginning of the massage procedure from distant areas (sacrum and others) to prevent negative reactions. The course of treatment is carried out from twelve to fifteen procedures, the time of the first procedures is 20-25, and the next 45-60 minutes. Repeated courses are possible not earlier than in 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, it is not necessary to rely on the constant help of 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 patient. The tips of the middle and ring fingers are placed 1-2 centimeters below the zygomatic bone. A series of short movements is performed under 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 meatus up along the border of the scalp, long movements are carried out to the upper edge of the temple. From the middle of the anterior border of the scalp to the upper edge of the temple, short and then long movements are performed with a repetition of 3-5 times. From the inner end of the eyebrow to the outer, departing from the superciliary arch by 1-2 cm, short movements are carried out. Short movements are carried out in the direction from top to bottom (to the eyebrow). The massage of the superciliary arches is closely adjacent to the lines in the temporal region, which are switched on as needed. Direction of movements from the outer corner of the eye obliquely upwards 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 same hand, while the free hand fixes the soft tissues at the outer corner of the eye. Indications for the inclusion of the forehead area in the massage procedure are headaches, accompanied by insomnia, irritability, anxiety, fear.

HOMEOPATHY WILL IMPROVE THE HEALING EFFECT

In the complex treatment of facial neuritis and trigeminal neuralgia, I recommend combining treatment with medicinal plants with a well-established complex of herbal homeopathic therapy. With the right selection of a constitutional remedy, it is possible to achieve not only a stable analgesic effect, but also a complete recovery. The use of homeopathic medicines as a symptomatic treatment in accordance with the clinical picture of the disease and the symptoms of the drug action contributes to a significant increase in the effectiveness of basic therapy. Homeopathic medicines should be combined with the above methods of phytotherapy treatment. One of the main remedies in the treatment of trigeminal neuralgia is Spigelia (spigelia). Especially with sudden, stabbing "dagger" pain. With severe, excruciating pain in the eyeballs and around the eyes, extending deep into the orbit. A decoction of mountain arnica helps relieve pain. Take a decoction of 0.5 cup 3-4 times a day and during an attack. You can also take the homeopathic preparation Arnica every 10 minutes. Argentum nitricum, Gelsemium, Lycopodium, and Rhus toxicodendron will also help, and can be taken every three hours until a suitable remedy is found for the particular case. 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 the instructions. Additionally, Mezereum (meserium) and Verbascum (verbascum) are used in trigeminal neuralgia with burning, shooting pains and numbness, as if a stream of cold air blows into the eye. It has a pronounced effect on the lower branch of the trigeminal nerve, on the ear, and on the respiratory organs. When pain in zygomatic bone, temporomandibular joint, and ear, especially on left side, with lachrymation, coryza, and sensation as if the affected parts were being squeezed by pincers, when talking, sneezing, changes in air temperature, and clenching the teeth, aggravates the pain. Combine herbal medicine and herbal homeopathy with lecithin (1000 mg with each meal), vitamin B complex, folic acid (400 mg) and vitamin B1 alone, all for a week. Take twice your daily dose of a multivitamin B complex twice a day. Chromium can be taken three times a day with food (in divided portions at the rate of 40 mg per 30 cm of growth). Ordinary oat extract is taken as a liquid - 1 tsp. l. liquid oat extract, diluted with water, every three hours. Any neurological symptoms that do not disappear for a long time, as well as in the case of an obvious serious injury to the nerves, should be consulted by a neurologist. If large nerves are affected, special examination methods should be used, 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 recede! The patient must believe that even before the expiration of 1.5 months, the pain will lose its acute character, the twitching of the muscles of the face will disappear, and the activity of the heart will normalize. Acupuncture and acupressure techniques can quickly relieve pain and promote healing. You can learn the specific techniques that are right for you by contacting an acupuncturist or shiatsu specialist or by using books on acupuncture.

DIET AND REST ARE COMPONENTS OF SUCCESS

Care for long-term chronic cases of trigeminal neuralgia should be special. In all cases, you must follow the dietary regimen. Some cases require a year or two to overcome the toxic condition as the cause of the disease and the exposure to pain, which often persists after the cause has been removed. It is necessary to turn on and apply willpower in order 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 refrain from taking 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 physical and mental state of the patient, and carefully guide and inspire him.

SYMPTOMS OF INFLAMMATORY OF THE TRIGUE NERVE

Of course, it is necessary to stop the use of alcohol, drugs that cause innervation and disorders in the body. Along with alcohol, tobacco and coffee must be abandoned. It is necessary to correct all innervating causes and addictions. And until the acute symptoms go away, absolute rest is needed. The cause must be eliminated - the factor of toxic irritation must be done away with, i.e. First of all, you need to eliminate toxemia. Rapid results in the removal of toxins gives fasting. In chronic cases rest and fasting are equally valuable. After the symptoms have disappeared, exercise (passive where necessary, active where possible and when possible) plus proper food and sunbathing will also contribute to healing, which neither massage nor treatment can ever do. For example, in the acute stage of neuritis, sunbathing is useful, care must be taken not to cause overheating, which increases pain.

AND A LITTLE MORE ABOUT PAIN RELIEF

Be careful about the side effects that classic pain relievers have. However, classic mild drugs such as aspirin, paracetamol, or acetaminophen can be used for pain relief if there are no individual contraindications due to the side effects of these drugs. In order to relieve prolonged 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 divided doses throughout the day. Pain is a subjective experience, so relaxation, biofeedback, and hypnosis may well help. Willow and meadowsweet also contain salicylic acid (aspirin). It is necessary, of course, to know the correct ways of preparing painkillers from them and the correct intake. And these are individual doses. In this case, always ready to advise and help. Remember also that when it is possible to achieve significant improvements in a short time, then repeated courses are carried out, including electric and mud therapy, acupuncture, and therapeutic exercises.

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

In total, a person has 12 pairs of cranial nerves, the largest of them is the trigeminal nerve (V pair).

It is mixed, in its composition it has both sensory and motor nerve fibers.

Therefore, trigeminal neuralgia is manifested by a violation of the sensitivity of certain facial areas, 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 causes that contribute to the onset of the disease:

Mechanical compression: the nerve at the exit from the bridge of the skull can be compressed by various pathological formations. There are several reasons for this pressure:

Vascular diseases leading to nerve compression: aneurysms (pathological changes in 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, after which post-traumatic cysts or scars form, compressing the nerve.
Congenital anomalies of the skull bones.

herpetic infection: one of the herpes viruses - Herpes zoster - causes 2 diseases in humans: when it first enters the body (usually in childhood) - this is chicken pox. After an infection, the virus persists (is in an inactive state) in the body throughout life and, with a decrease in immunity, it can manifest itself as another disease - shingles.

This disease is far from being as harmless as chickenpox, because. affect sensitive nerves, (in particular, the trigeminal), along which herpetic eruptions are also localized. Postherpetic trigeminal neuralgia occurs.

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

Odontogenic causes:

jaw injuries;
bacterial infection of the teeth;
consequences of dental treatment (filling, extraction of teeth, etc.).

Such a disease as brings real torment to a person, because the pain is so severe that no painkillers help. What is the cause of this pathology?

Read more about the symptoms and treatment of trigeminal neuritis.

Not always with trigeminal neuralgia, medications and surgical intervention are prescribed. In such cases, you can save yourself 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 on the trigeminal nerve of certain factors, its demyelination occurs. In other words, damage to the myelin sheath of the nerve occurs, leading to a violation of its conduction.

The conduction pathology causes a violation of the inhibition of nerve impulses, as a result of which the nuclei of the trigeminal nerve (located in the middle and hindbrain) are re-irritated. This is how the pain syndrome starts.

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

ophthalmic 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 the facial nerves

Therefore, depending on which branch of the nerve is affected, a change in sensitivity and pain can be in different facial areas. On defeat:

I branch - in the upper eyelid, eyeball, inner corner of the eye, nose, forehead skin and scalp.
II branches - in the upper jaw (including the teeth and the maxillary or maxillary sinus), the upper lip and cheek, in the region of the lower eyelid and the outer corner of the eye;
III branch - in the lower jaw (including 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

Pain attacks in trigeminal neuralgia can be of two opposite types:

intense shooting pain lasting up to 3-4 minutes;
prolonged burning exhausting pain, lasting up to several days.

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

At the time of an attack of neuralgia, a person freezes, afraid of further intensifying unbearable pain with unnecessary movements. Sometimes patients may rub their cheeks in an attempt to relieve an attack. The pain can cause the muscles of the affected part of the face to spasm (tic pain).

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

In addition, pain can occur during normal daily activities:

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

Some factors can contribute to the development of an attack: diseases of the ENT organs (sinusitis, sinusitis, rhinitis), SARS, nervous overexcitation, the use of certain foods (spicy foods, alcohol, chocolate, etc.), migraine attacks.

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

Consequences of trigeminal neuralgia

The long course of the disease can leave permanent changes on the face, because. there is a violation of blood and lymph circulation in the affected area, respectively, tissue nutrition worsens (trophic disorders). In addition, being afraid to cause an attack of neuralgia with unnecessary movements, the patient begins to spare the affected half, which can lead to muscle hypotrophy (they become thinner, their function decreases).

All this manifests itself as follows:

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

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

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

Diagnosis of the disease

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

Characteristic features are specified:

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

Also, during the survey, it turns out whether the patient has a history of factors or diseases that contribute to the development of pathology (vascular disease, tumors, head injuries, herpes infection, etc.).

Examination: the patient avoids palpation of the "pain" zones on the face. With a long course, facial changes can be observed (described above). The general condition of 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 posture or kneads his face with his hands, there is reddening of the skin on the affected side, lacrimation is possible, profuse salivation. The pulse usually quickens, blood pressure may rise.

Instrumental Methods:

Computed (CT) and magnetic resonance imaging (MRI) - to examine for the presence of brain tumors, pathologically altered vessels, signs of multiple sclerosis.
Electroneurography - reveals pathological changes in the conduction of a particular 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 nuclei of the trigeminal nerve.

Laboratory diagnostics: generally uninformative in establishing the diagnosis. However, if there is evidence of a herpes infection in the anamnesis, it is possible to examine the blood for the presence of antibodies to the Nerpes zoster virus.

Treatment of inflammation of the trigeminal nerve on the face

Medical therapy:

Antiepileptic drugs are the main treatment for trigeminal neuralgia. Carbamazepine (Finlepsin) is most commonly used, but phenytoin, gabantin, and others can also be used.

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

A 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 - contribute to the restoration of nerve fibers.
Sedatives and antidepressants - to reduce the psycho-emotional stress in the patient.

Surgical treatment- with the ineffectiveness of conservative therapy:

Microvascular decompression is a neurosurgical operation in which the impact on the trigeminal nerve of a pathologically altered vessel is eliminated (a protector is installed between the vessel and the nerve).
Removal of tumor formations leading to nerve compression.
Removal of the trigeminal nerve - is carried out in extreme cases, since persistent side effects may remain, for example, a change in facial expressions.

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

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