neuralgia

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Classification according to ICD-10
M79.2 Neuralgia and neuritis, unspecified
ICD-10 online (WHO version 2019)

Neuralgia is the medical term for nerve pain (from ancient Greek νεῦρον neuron "nerve" and ἄλγος algos "pain"). It describes pain that spreads in the supply area of ​​one (or more) nerves ( innervation area ) and is caused by them. In a narrower sense, it describes neuralgiform pain .

The adjective neuralgic is also used figuratively for something that is particularly sensitive or prone to interference .

Emergence

Neuralgia results from damage to peripheral nerves . These can be caused by pressure (mechanical, e.g. in the case of a herniated disc ), inflammation ( neuritis , e.g. in herpes zoster ), metabolic disorders (metabolic, in diabetes mellitus etc.), radiation (actinic) or e.g. B. Chemical burns occur. A distinction must then be made between several damage patterns, which can also occur side by side:

  • Damage to the medullary sheath (insulation layer), demyelinating: This exposes the nerve fibers and, consequently, causes electrical impulses from nerve fibers to jump over to the sensation of touch on pain fibers. This leads to shooting intense pain (neuralgiform pain)
  • Damage to the nerve fiber, axonal: If the information line is blocked (deafferentation), there is a lack of information in the central nervous system. For reasons that are not fully known, initially a feeling of numbness occurs in the CNS , but then it is not uncommon for painful sensations (deafferentation pain).
  • Circulatory disturbance in the nerve: Pressure on the nerve results in a local circulatory disturbance and thus a metabolic disturbance, which leads to severe pain. The rapid relief when the mechanical problem is removed is typical.

treatment

The cause and type of pain should be considered during treatment. Causal therapy is usually more effective (e.g., surgical removal of compression) than symptomatic therapy. However, the individual risk of the operation must be taken into account.

In neuralgia with shooting (neuralgiform) pain, anticonvulsants or opioids are more effective, and in persistent pain, anti-inflammatory drugs and antidepressants are more effective . Therapeutic regional anesthesia and TENS are also effective.

Demarcation

The term neuralgia is sometimes used uncritically. Physicians, too, tend to describe every facial pain as trigeminal neuralgia , although it conceals at least as many "persistent idiopathic facial pain" and other disorders as the temporomandibular joint syndrome.

A neuralgiform pain is shooting, short, very intense and can be triggered by stimulating other sensitive qualities (touch, temperature, etc.).

Typical examples

In principle, any nerve can lead to neuralgia if damaged accordingly. However, the following nerves are often affected:

Trigeminal neuralgia is the most common neuralgia in the head and neck area; it is estimated at 10–20 per 100,000 inhabitants. This is followed by glossopharyngeal neuralgia, which is 100 times less common.

See also

literature

  • Cornelia Fischer-Börold, Siglind Zettl: Pain. Visite - The Health Library. Schlütersche, 2006, ISBN 3-89993-521-7 .
  • Peter Wessely: Neuropathic Pain. Springer, 2001, ISBN 3-211-83666-7 (scientifically demanding).

Web links

Wiktionary: Neuralgia  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ Duden.de: neuralgisch, meaning 2 , accessed on May 16, 2020