Neuralgia

Definition

Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve.

Common neuralgias include:

Alternative Names

Nerve pain; Painful neuropathy; Neuropathic pain

Causes

Causes of neuralgia include:

In many cases, the cause is unknown.

Postherpetic neuralgia and trigeminal neuralgia are the two most common forms of neuralgia. A related but less common neuralgia affects the glossopharyngeal nerve, which provides feeling to the throat.

Neuralgia is more common in elderly people, but it may occur at any age.

Symptoms

Exams and Tests

Your doctor or nurse will examine you and ask questions about your medical history and symptoms, including:

The exam may show:

You may also need to see a dentist if the pain is in your face or jaw. A dental exam can rule out dental disorders that may cause facial pain (such as a tooth abscess).

Other symptoms (such as redness or swelling) may help rule out conditions such as infections, bone fractures, or rheumatoid arthritis.

There are no specific tests for neuralgia, but the following tests may be done to find the cause of the pain:

Treatment

Your doctor will:

Treatment varies depending on many things, including the cause, location, and severity of the pain.

Strict control of blood sugar may speed recovery in people with diabetes who develop neuralgia.

Medications to control pain may include:

Other treatments may include:

Unfortunately, these procedures may not improve symptoms and can cause loss of feeling or abnormal sensations.

When other treatment methods fail, doctors may try nerve or spinal cord stimulation, or more rarely a procedure called motor cortex stimulation (MCS). An electrode is placed over part of nerve, spinal cord, or brain and is hooked to a pulse generator under the skin. This changes how your nerves signal and may reduce pain.

Outlook (Prognosis)

Most neuralgias are not life threatening and are not signs of other life-threatening disorders. However, pain can be severe. For severe pain that does not improve, see a pain specialist so that you can explore all treatment options.

Most neuralgias will respond to treatment. Attacks of pain usually come and go. However, attacks may become more frequent in some patients as they get older.

Sometimes, the condition may improve on its own or disappear with time, even when the cause is not found.

Possible Complications

When to Contact a Medical Professional

Contact your health care provider if:

Prevention

Treating related disorders such as diabetes and renal insufficiency may prevent some neuralgias. Strict control of blood sugar may prevent nerve damage in people with diabetes. In the case of shingles, there is some evidence that antiviral drugs and a herpes zoster virus vaccine can prevent neuralgia.

References

Digre KB. Headaches and other head pain. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 405.

Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, Pa: Saunders Elsevier; 2012:chap 76.

Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 428.