A ‘neuralgia’ is any pain arising from a nerve. The nerve may be irritated, compressed by a bone/disc, infected, or affected by some other lesion. Trigeminal neuralgia, for example, is often caused by a blood vessel pressing on the trigeminal nerve as it emerges from the brain stem. This causes the protective material around the nerve to break down, making it more sensitive. Other causes include things like shingles, multiple sclerosis (MS), tumours, and arteriovenous malformations (AVMs).
Trigeminal neuralgia
Trigeminal neuralgia is a painful condition, causing severe facial pain on one side of the face. The pain can be felt over the front of the scalp, forehead, cheek, gums, and around the jaw. It is caused by a disorder of the trigeminal nerve. Sometimes this is due to pressure on the nerve from a blood vessel, or potentially from multiple sclerosis or other lesions/abnormalities on the nerve. It causes brief electric shock-like pains that last anywhere between a few seconds to a few minutes. The attacks occur anywhere from 3 to over 100 times per day, often coming in quick succession over a period of a couple of hours. Sometimes attacks are spontaneous, but they can also be triggered by contact with the face, such as applying makeup, shaving, brushing your teeth, or even just the wind.
A less common type of trigeminal neuralgia causes a constant burning pain, which is normally less severe. Treatments include antiseizure medications or medications used for nerve pain, or if these don’t work, surgery may be considered. Many people develop depression or anxiety in association with trigeminal neuralgia, as it becomes a distressing and uncontrolled condition to live with.
Occipital neuralgia
Occipital neuralgia causes paroxysmal or stabbing pain in the rear (posterior) part of the scalp, caused by a lesion on or dysfunction of the greater, lesser and/or third occipital nerve (a branch of spinal nerve root C3). It is associated with abnormal tenderness on the scalp, causing discomfort and pain when touching the scalp or hair. Occipital neuralgia can be temporarily treated with a local anaesthetic block for the affected nerve(s).
Glossopharyngeal neuralgia
Similar to trigeminal neuralgia, but occurring in the ear, base of tongue, tonsils & under the angle of the jaw.
Nervus intermedius neuralgia
Shooting pain felt in the ear (auditory) canal or radiating to the upper back of the scalp (parieto-occipital region). Possible causes include shingles, multiple sclerosis, or tumour.
Further information
Trigeminal Neuralgia – Brain Foundation
Multiple Sclerosis – Brain Foundation
Facial Pain Disorders – other disorders caused by inflammation or irritation of the nerves
