Neuralgia is a sharp, shocking pain that follows the path of a nerve and is due to irritation or damage to the nerve.
See also:
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.
The health care provider will take a complete history, including:
An examination may show:
A dental examination 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:
The goal of treatment is to reverse or control the cause of the nerve problem (if found), and provide pain relief. Treatment varies depending on the cause, location, and severity of the pain, and other factors. Even if the cause of the neuralgia is never found, the condition may improve on its own or disappear with time.
Surgery to remove pressure on the nerve from nearby bones, ligaments, blood vessels, or tumors may be needed.
See:
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 motor cortex stimulation (MCS). An electrode is placed over part of the brain and is hooked to a pulse generator under the skin.
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.
Contact your health care provider if:
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.
Nerve pain
Shy ME. Peripheral neuropathies. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 446.
Cutrer FM, Moskowitz MA. Headaches and other head pain. In: In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 421.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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