How long does it take to treat the trigeminal nerve? Inflammation of the trigeminal nerve. Causes of trigeminal neuritis

Update: December 2018

Before describing the symptoms of neuralgia trigeminal nerve, let's try to explain what the trigeminal nerve is. As is known, in human body 12 pairs of cranial nerves. The trigeminal nerve is a representative of the fifth pair. It consists of three branches - ophthalmic, mandibular and maxillary. Thus, if the ophthalmic branch of the nerve is affected, the pain will be localized in the forehead, temple, and brow ridge.

When the 2nd branch is affected, pain manifests itself in the nose area, upper jaw, facial muscles. Damage to the 3rd branch is characterized by pain localized in the area of ​​the lower jaw, chin, and neck. Often, when the second and third branches are affected, severe toothache occurs.

Types of neuralgia

Conventionally, all types of trigeminal neuralgia can be divided into primary (true) and secondary neuralgia.

• Primary (true) neuralgia is considered a separate pathology that occurs as a result of compression of the nerve or impaired blood supply in this area.
• Secondary neuralgia is the result of other pathologies. These include tumor processes and severe infectious diseases.

Neuralgia can affect all nerve branches at once, or manifest itself as inflammation of one or two branches.

Causes of neuralgia

In order to pick up adequate treatment trigeminal neuralgia, you need to have a good understanding of the causes of the disease. And there are many of them:

• Compression of all or one branch of the trigeminal nerve;
• Inflammatory diseases paranasal sinuses nose
• Dental diseases;
• Chronic infectious diseases – tuberculosis, brucellosis, malaria;
• Metabolic disorders – diabetes, gout
• Brain tumors (see)

Signs of the disease

Trigeminal neuralgia produces fairly clear symptoms, so diagnosing the disease does not cause difficulties. The disease is characterized by the appearance of a sharp, burning pain in the face, appearing suddenly. The painful attack does not last long, for a maximum of 2 minutes or seconds (10-20), after which it goes away on its own. As we wrote above, pain occurs in the area where one of the three branches of the nerve is affected. Patients who suffer most are those in whom all three branches of the trigeminal nerve are affected.

The pain always occurs on one side of the face. Sometimes it can be transient - affecting one branch of the nerve, then another. Pain radiates to the eye, ear, neck, occipital region, patients call this pain shooting and compare it to an electric discharge.

An attack of neuralgia is accompanied by convulsive contractions of the facial (facial, chewing) muscles, while the patient does not scream or cry, but tries to minimize movements. Patients experience increased salivation, lacrimation, and sweating (see). The skin turns red and signs of rhinitis may appear.

Pain occurs both for no apparent reason and with additional irritations: talking, shaving, chewing. During the periods between painful attacks, no signs of the disease can be detected. Sometimes there is slight pain if you press on the exit points facial nerve.

Usually the location of pain remains unchanged for several years. Since patients with such neuralgia more often chew food on the healthy side, over time, muscle thickening, dystrophy of the masticatory muscles, and decreased sensitivity may occur on the affected part of the face.

The disease is characterized by excruciating pain. When collecting anamnesis and examination, doctors note that patients talk with horror about the pain they suffered, trying not to touch the area of ​​the face where the attack occurred. Patients are usually tense and anxious in anticipation of an exacerbation of neuralgia. This must be taken into account when choosing a treatment method for trigeminal neuralgia - it is very important to reassure the patient, instill in him confidence that the treatment will be effective and the pain will not return.

Which doctor should I contact? Having experienced an attack of severe facial pain, especially if it manifests itself in the area of ​​the jaws and teeth, most patients associate its occurrence with dental pathologies. This is not true. Your road lies to a doctor - a neurologist.

How to treat trigeminal neuralgia?

To treat this disease, medication, physiotherapy and surgery are used.

Drug treatment

Carbamazepine is considered the main drug for the treatment of trigeminal neuralgia. It develops inhibitory processes in nerve cells that are prone to paroxysmal activity(painful excitement). The dosage of the drug is selected by the doctor, so we will not dwell in detail on the drug regimens used. Let's just say that carbamazepine is taken for a long time, up to 8 weeks.

In addition, the drug is quite toxic. Affects the liver, urinary and bronchial systems. Among side effects from taking carbamazepine, various mental disorders, memory impairment, drowsiness.

Carbamazepine is contraindicated in pregnant women. The drug has a teratogenic effect - it has a toxic effect on the embryo. Carbamazepine should also not be taken by persons with glaucoma, heart blocks, or blood diseases.

Interesting! It is known that when taking carbamazepine you should not drink grapefruit juice - it increases toxic effect drug.

We hope that we have convinced you not to take carbamazepine under any circumstances without a doctor’s prescription. When taking this drug for trigeminal neuralgia, the symptoms stop after 1-2 days, its analgesic effect is felt, which lasts 3-4 hours.

• Similar drugs, anticonvulsants, can also be used in the complex treatment of trigeminal neuralgia. These are Phenibut, Pantogam, Baclofen.
• To relieve a painful attack, ambulance specialists can use intravenous administration sodium hydroxybutyrate. However, the effect of such injections is short-lived; pain is relieved for several hours.
• may enhance therapeutic effect carbamazepine (Pipolfen, Diphenhydramine).
• Tranquilizers (Tazepam, Diazepam) and antipsychotics (Pimozide) are prescribed, as additional drug neurologists can use a long-term course that is well known to you.
• For diseases of the cerebral vessels, vasotonics can be prescribed - Cavinton, Trental, A nicotinic acid and etc.
• Vitamin therapy, especially vitamin C and B vitamins. The latter are often prescribed in injection form at acute period diseases.
• Non-steroidal anti-inflammatory drugs - see.

Physiotherapeutic treatment

Physiotherapeutic treatment is prescribed in combination with medication. The following methods are used:

• Acupuncture;
• Ultrasound;
• Laser treatment;

Radical treatment

If there is no effect from the conservative treatment the patient can be offered a solution to the problem surgically. Currently there are several types radical treatment. Let's take a closer look at these methods:

• Rhizotomy

The trigeminal nerve is ruptured through a skin incision behind the ear, which achieves a therapeutic effect.

• Microvascular decompression

The operation is performed by neurosurgeons. This operation removes or moves blood vessels who are in contact with nerve roots. The effectiveness of such an operation reaches 80%.

• Radiofrequency ablation

Impact on the nerve ganglion high temperature. Treatment is carried out using local anesthesia. Hospitalization is not necessary. The pain does not stop immediately; final recovery occurs after a month.

• Glycerin injections

They are carried out using a long thin needle, with which the doctor penetrates the area of ​​​​the branching of the trigeminal nerve. Injections help well, but sometimes there are relapses of the disease at a later date.

New developments

The most modern and effective methods Treatment of trigeminal neuralgia can be called radiosurgery using Cyber ​​Knife. This device uses a photon beam for treatment, which penetrates precisely into the area of ​​inflammation and eliminates it. Treatment with Cyber ​​Knife provides high precision radiation doses, comfortable and fast healing. In addition, the procedure is absolutely safe for the patient.

Modern treatment using Cyber ​​Knife can be considered the most effective. This technique is used not only abroad, but also in the vast former USSR: in Russia, Ukraine, Belarus. For your information, treatment in Moscow will cost 180,000 rubles.

The nervous system is usually divided into two sections - peripheral and central. The brain and spinal cord are classified as central; the nerves of the back and head are connected directly to the central nervous system and represent peripheral section. Nerve impulses from all parts of the body are transmitted precisely through the central nervous system to the brain, and feedback is also provided.

Anatomy of the trigeminal nerve

There are twelve pairs of cranial nerves in the human body. The trigeminal nerve system is the fifth pair and is divided into three branches, each of which is directed to a specific area - the forehead, lower jaw and upper jaw. The main branches are divided into smaller ones, which are responsible for transmitting signals to parts of the face. Anatomy ternary nerve looks like a system of nerve endings that originates from the pons. The sensory and motor roots form the main trunk directed to the temporal bone. The location of the branches is as follows:

1. orbital;
2. ramus of the maxilla;
3. mandibular;
4. trigeminal ganglion.

With the help of these branches, impulses are transmitted from the nose, eyes, oral mucosa and skin to the main nerve trunk.

Where is the nerve located: location diagram on the face

Originating in the cerebellum, the trigeminal nerve has many small branches. They, in turn, connect all the facial muscles and the areas of the brain responsible for them. Control various functions and reflexes are carried out with the help close connection with the spinal cord. The trigeminal nerve is located in the temporal region - smaller branching endings diverge from the main branch in the temple area. The branching point is called the trigeminal ganglion. All small branches connect the organs of the front part of the head (gums, teeth, tongue, mucous membranes of the nasal and oral cavity, temples, eyes) with the brain. The location of the trigeminal nerve nodes on the face is shown in the photo.

Functions of the facial nerve

Sensory sensations are provided by impulses that transmit nerve endings. Thanks to fibers nervous system a person is able to feel touch, sense differences in ambient temperatures, control facial expressions, and carry out various movements with lips, jaws, and eyeballs.

If we consider in more detail what the trigeminal nerve system is, we can see the following picture. The anatomy of the trigeminal nerve is represented by three main branches, which are further divided into smaller ones:

Neuralgia as the main pathology of the nerve

What is inflammation of the trigeminal nerve? Neuralgia, or as it is commonly called - facial neuralgia, indicate the development of inflammatory processes in the tissues of the trigeminal nerve.

Reasons pathological processes affecting the branches and branches of the trigeminal nerve can become viral and bacterial diseases, such as herpes, polio, HIV, sinusitis, diseases of the ENT organs.

The exact factors causing the pathology have not yet been studied, although the main causes of the disease are known:

1. infectious diseases that provoke the formation of adhesive processes in tissues;
2. formation on the skin, temporal and jaw joints scars as a result of injuries;
3. development of tumors at the points of passage of nerve branches;
4. congenital defects in the location and structure of blood vessels in the brain or cranial bones;
5. multiple sclerosis, which leads to partial replacement of nerve cells with connective tissue;
6. pathologies of the spine (for example, osteochondrosis), causing increased intracranial pressure;
7. dysfunction of the blood vessels of the head.

Symptoms of inflammation

Inflammatory process branches of the trigeminal nerve affects nerve fibers individually or several together; pathology can affect the entire branch or just its sheath. The facial muscles become excessively sensitive and react even to a light touch or movement with bouts of burning acute pain. Frequent symptoms inflammation of the trigeminal facial nerve are:

• exacerbation pain and increased frequency of attacks during the cold season;
• attacks most often begin suddenly and last from two to three to thirty seconds;
• pain occurs in response to various stimuli(brushing teeth, chewing movements, touching);
• the frequency of attacks can be very unpredictable - from one to two per day before the onset severe pain every 15 minutes;
• a gradual increase in pain and an increase in the occurrence of attacks.

The most common inflammation is unilateral inflammation of the trigeminal nerve. At rapid growth Wisdom teeth put pressure on nearby tissues, which can result in neuralgia. An involuntary profuse drooling, secretion of mucus from the sinuses, convulsive contractions of the facial muscles. Patients try to avoid eating or talking so as not to provoke the onset of another attack. In some cases, its onset is preceded by a feeling of numbness and tingling of the facial muscles, and paresthesia occurs.

Complications

If you ignore the signs of the onset of trigeminal nerve disease, over time you can get a number of complications:

Diagnostics

Diagnosis of inflammation of the trigeminal nerve is carried out by a specialist and includes anamnesis and examination to assess the location of pain. Based on the results of the initial examination, the doctor decides on the need for comprehensive survey, directing the patient to undergo computer diagnostics and MRI (magnetic resonance imaging). Electroneuromyography or electroneurography may be prescribed. It is recommended to consult an ENT specialist, dentist and surgeon.

The frequency of attacks, as well as the actions, direction and strength that provoke them, are important. The place where it takes place main nerve plays the most important role. The examination is carried out by a doctor both during remission and during exacerbation. This is done to more accurately determine the condition of the trigeminal, dental and other nerves of the face, and which branches of the trigeminal nerve are affected to a greater extent. An important factor is the assessment mental state patient, condition skin, presence or absence of muscle cramps, pulse readings and blood pressure. Neuralgia can be triggered by painful and traumatic removal of a wisdom tooth.

Treatment methods for neuralgia

To successfully treat trigeminal nerve inflammation, comprehensive A complex approach. It is necessary not only to eliminate the symptoms, but also to get rid of the factors that provoked the occurrence of the pathology. The package of measures includes treatment with medications, massotherapy and a course of physiotherapy.

• Drug therapy involves a blockade - intramuscular injections, reducing muscle spasm.
• At viral nature For inflammation of the trigeminal nerve, antiviral tablets are prescribed.
• To reduce discomfort and relieve pain syndrome The doctor prescribes painkillers.
• The complex of drug therapy includes the use of non-steroidal anti-inflammatory drugs that specifically affect the inflammation process.
• To remove convulsive syndrome and others discomfort anticonvulsants, muscle relaxants, antihistamines, antidepressants and sedatives.
• We must not forget about supporting the immune system weakened by the disease and the central nervous system. It is necessary to take a complex of vitamins, Special attention is given to B vitamins, which have a strengthening effect on the nervous system.

A course of physiotherapy is carried out using the following procedures:

Using the influence of magnetic fields and currents high frequency circulatory function is restored and muscles relax. The use of electrophoresis with drugs has proven itself in the fight against inflammation of the trigeminal nerve.

The triadic nerve consists of three branches that arise from the brain stem and spread out of the skull through three different foramina. They reach the surface of the face and supply it with nerves, thereby ensuring continuous communication with the central nervous system.

The first branch is located symmetrically and the exit points are located slightly above the eyebrows. As for the second branch, it is located below the eyes on both sides of the nose in the cheek area. Well, the third branch is located in the lower area of ​​the jaw and spreads from the corners of the mouth, heading towards the center.

In the medical literature, inflammation of the trigeminal nerve is called “trigeminal neuralgia.” A person who suffers from trigeminal neurology experiences indescribable pain.

Causes of inflammation of the ternary nerve

The triadic nerve may be affected by a meningioma, neuroma, or scarring in the brain stem. There are times when the pressure on the brain stem provokes vasodilation or sclerotic changes in the arteries. The nerve may be damaged due to a bacterial or viral infection.

Trinitarian neuralgia occurs extremely rarely and, as a rule, occurs in women who are between the ages of 50 and 69 years. Inflammation of the ternary nerve in young men is a consequence of sclerotic changes in the body.

Manifestation of pain during inflammation of the ternary nerve

Patients, as a rule, feel spontaneous, which can be compared to a discharge electric current, since it manifests itself, on the one hand, and has a shooting character. It is worth noting that pain appears superficially. They do not penetrate deeply, are moderate or very strong. Painful attacks last no more than two minutes, but patients are sure that this goes on forever. Attacks of pain are very difficult to bear, as they are repeated several times during the day.

In every patient, pain is provoked various factors. As a rule, this can be any facial movement, smile, shaving, conversation, etc. light touch, eating and even brushing teeth. Patients try not to provoke pain attacks, which is why they try to exclude pain-provoking factors from their diet. Such actions significantly worsen the quality of life. Sometimes a long time passes between attacks of pain, which can even last several months.

Pain is localized and distributed according to the areas of innervation of one or two nerve branches.

Painful attacks in the area of ​​the ophthalmic nerve (first branch) radiate to the eyes, temples and forehead.

Pain attacks in the area of ​​the maxillary nerve (second branch) can be felt in the upper jaw, upper teeth, upper lip, cheeks in the area below the eyes.

Pain attacks in the area mandibular nerve(third branch) are given off in the lower jaw, lower lip and lower teeth.

Painful attacks on the face can be provoked chicken pox, herpes or another virus that damages the trigeminal ganglion. The first signs of the disease include increased body temperature, redness of the face and increased sensitivity on one side of the face.

Particular attention should be paid to any rashes on the face. The disease can also affect the cornea of ​​the eye or the mucous membrane of the soft palate. Changes can occur even for two months and if not started timely treatment, this can lead to long-term pain attacks that will last for several years, or even a lifetime. If you have the above symptoms, you should immediately consult a doctor and begin treatment.

How to understand that it is the ternary nerve that is inflamed?

The main three branches of the triangular nerve have branches throughout the face. Inflammation of the small branches of the main nerves also provokes. Sometimes these attacks of pain are very difficult to distinguish from the symptoms of other diseases.

Nasociliary nerve arises from the first branch and innervates the frontal sinus, bridge of the nose and eyeball. Damage to this nerve due to facial trauma or sinus disease causes acute pain in the frontal and nasal region that lasts several hours. The eyes may also become watery. Constant aching and dull pain is observed between painful attacks.

The superior alveolar nerve arises from the second branch and innervates the gums and upper teeth. This nerve is very often damaged due to jaw injuries or dental procedures. If this particular nerve is inflamed, then pain will not occur due to temperature changes. In other cases, sharp pain will occur in the gums and upper teeth, and between attacks there is a dull pain.

The mandibular nerve arises from the third branch. Its irritation or damage can be caused by injuries to the jaw or surgical intervention, as well as the removal of lower teeth.

Patients feel pain in the lower lip, and sometimes in the ears and chin. The pain manifests itself more intensely, so after attacks of pain, patients feel dull pain. Changes in temperature are not provoking factors in these cases.

Poorly made dentures for teeth, facial injuries, inflammation maxillary cavities can cause injury to the buccal nerve that comes off from the third branch, innervating the skin of the corners of the mouth, gums and buccal mucosa. The patient feels moderate pain in the temples and cheek area.

Damage to the lingual nerve causes unpleasant pain. It arises from the third branch and innervates the first two-thirds of the tongue. Damage can occur due to oral trauma, improperly made dentures, or sharp tooth edges. As a result of such damage, acute pain occurs with a simultaneous burning sensation. The patient's tongue also becomes numb and salivates profusely. The pain is more intense when talking, as well as when eating or drinking cold water.

The third branch also divides into the auriculotemporal nerve, which innervates the skin of the temporal region, part of the external ear, the external auditory canal And parotid gland. Any disease associated with this branch provokes attacks of pain in the temporal region and deep in the ear.

When on glossopharyngeal nerve influences pressure from scarring, sclerotic lesions of the arteries or other processes occurring in nearby tissues, these changes provoke severe pain that passes through the throat and the root of the tongue. Sometimes pain is felt in the ears, eyes and jaw. The attack of pain intensifies while eating and swallowing food, as well as when talking. Painful attacks can last for several days and are simply unbearable for the patient. Between attacks, patients feel a dull pain at the root of the tongue.

Not just the trigeminal nerve

Attacks of facial pain provoke damage to other neural structures. An obvious example is tonsillitis, inflammation of the paranasal sinuses and other processes that can cause damage to the autonomic ganglion. The symptoms are reminiscent of facial neuralgia, and causes pain in the eyes, teeth, face, root of the nose, base of the skull and temples. Patients often hear ringing and noise in the ears.

Due to trauma, dental treatment and tonsillitis, the autonomic ganglion, which is localized below the lower jaw, can be provoked. When it is damaged, the patient experiences dull and simultaneous pain. For 10-15 minutes in the area below the jaw may occur sharp pain, which is accompanied profuse salivation and swelling of the tongue. Painful sensations can be provoked by palpation triangle under the lower jaw.

Sometimes, due to lack of data, trigeminal nerve pain is confused with upper cervical syndrome sympathetic node. Unlike inflammation of the ternary nerve, this syndrome occurs due to pathologies lymph nodes, lungs, spine and other surrounding tissues.

In the case of the syndrome, the pain is localized in the entire face. The patient also experiences burning and acute pain in the teeth and mouth. On the affected side of the face, sensitivity increases, with a simultaneous reduction in the pupil and drooping of the corresponding eyelid. The patient develops tachycardia, and changes in blood pressure increase.

Treatment of inflammation of the ternary nerve

The classic symptoms of trigeminal neuralgia include short-term, shooting, superficial, severe pain followed by periods of its absence. But sometimes the symptoms of the disease resemble otolaryngological or dental diseases that arise due to damage branches of the main branches of this nerve. Therefore, if the doctor does not find any pathology, the patient should consult a neurologist. For effective treatment, it is very important to find out the cause of the pain, so the doctor may prescribe a computer scan, magnetic resonance imaging, or angiography.

In some cases, treatment of the trigeminal nerve does not produce results. Therapy only reduces pain, thereby alleviating the patient's suffering. In all other cases, treatment gives positive result, only if you use specially selected combinations of medications.

Sometimes doctors prescribe surgical intervention, which provides therapeutic effect. Reflexology and therapeutic blockades are also prescribed.

VIDEO

We treat inflammation of the ternary nerve using traditional medicine

Elderberry for inflammation of the ternary nerve

The facial nerve is connected to the nerve plexuses and arteries. Many lead to him nerve plexuses from the oral cavity, ear canal, back of the head, temporal artery and other parts of the face. Medical practice shows that facial nerve disease affects women in adulthood. They begin to feel severe pain on the side of the face in the area facial nerve. For the first time, ice applied to the affected area helps, but this will only relieve the pain for a while. These painful attacks will recur more and more often.

For facial paralysis, it is very useful to use elderberries for treatment. All you need is elderberry puree. It only takes a few minutes to prepare this product. First, take the berries and steam them a little, and then chop them. A compress of berry puree should be done twice a day, morning and evening.

Japanese Shiatsu massage in the treatment of the trigeminal nerve

To treat inflammation of the facial nerve, Japanese Shiatsu massage is very effective. With its help, you can relieve fever and fatigue from the facial nerves, without additional costs for medications. There are eight points on the face and neck. In order to remove heat from the main points of the nerve branches, you need to apply pieces of ice to these points. Before you start wiping your face with ice, you need to put on gloves. The points are massaged in order.

Point No. 1– located above the eyebrow.

Point No. 2– located above the eye.

Point No. 3- located under the cheekbone.

Point No. 4– located on the edge where the wing of the nose is.

Point No. 5– between the chin and lower lip.

Point No. 6- on the temples.

Point No. 7- in front of the ear.

Point No. 8- on back side neck.

The neck must be massaged on both sides of the spine, going lower. All actions are performed by rotational movements of the ice. At the eighth point you need to stop for 10 seconds and wait. It is worth noting that each point requires the same amount of time. Once you have completed all the manipulations with ice, take off your gloves and touch the massaged points with your hands. Then put on gloves and repeat the massage of each point using ice.. Then warm up the points again. These steps need to be repeated three times, after which you will feel relief. It is temperature changes that help reduce pain attacks.

Treating facial paralysis with dates

There is a huge chance that if the base of the facial nerve is damaged, part of the face will be paralyzed. The following traditional medicine recipe will help you get rid of facial paralysis. The beauty of this recipe is that it also treats stroke. All you need is a meat grinder and dates..

Take ripe dates and peel them and remove the pits. Then pass the prepared dates through a meat grinder, and that’s it. For getting positive effect for treatment, this remedy should be taken three teaspoons three times a day. If you find it difficult to take, the medicine can be diluted with milk or any other liquid. The course of treatment with traditional medicine consists of one month.

The trigeminal nerve is the fifth pair of 12 existing cranial nerves. Trigeminal nerve ( name on Latin- nervus trigeminus) is the largest of the cranial nerves. Its name is closely related to the structure. The nerve consists of three main branches. The first two branches are sensitive ( sensory), the third branch of mixed structure - carries out sensory and motor functions. In addition, among the main dendritic branches of the nerve there are secretory branches responsible for the innervation of the glands of the facial area.

The branches of the nerve innervate certain facial areas, which is where they got their names:
Orbital ( visual) nerve – superior branch. Responsible for sensitive sensations of the following parts of the face: forehead, conjunctiva, upper eyelid eyes, nasal mucosa, meninges and etc.;
Skulova ( maxillary) nerve – middle branch. Carries sensory information from the nostrils, lower eyelid and upper lip, sky, upper teeth, sinuses, etc.;
The mandibular nerve is the lower branch. Collects information from the lower teeth, gums, lips, chin and lower part of the outer ear, etc. In addition, it ensures the motor function of the innervated muscles.

According to the diagram, you can imagine the location of the nerve from its beginning to the periphery as follows. The motor nerve nuclei originate from the hindbrain region. The sensory fiber nuclei begin in the midbrain. Motor nerves emerge from the pons, forming a motor root to which medulla Sensory fibers join to form a sensory root. The motor and sensory roots together form a trunk, which penetrates under the hard shell of the cranial fossa and lies in a special depression located at the top of the pyramid of the temporal bone. In this area the trigeminal ( Gasserov) node from which three sensory branches of the nerve originate. Motor fibers are not part of the node. Their branch is located under the trigeminal ganglion, which exits through foramen ovale and joins the mandibular branch. The number of nerve branches on the left side of the jaw is noticeably greater than on the right side.

Functions of the trigeminal nerve

Embryonic development

Diseases

Causes of neuralgia:
injuries;
infection, one of the causes of which is carious teeth;
tumors;
nervous disorders, etc.

During an attack, pain can be felt on one side or simultaneously on both sides of the face. Usually the attack lasts several minutes. The pain may occur several times during the day. The disease is more common in middle-aged women.

Trigeminal neuritis is an inflammation of not only its sheath, but also the nerve itself.
Causes of neuritis:
viral (eg herpes) or bacterial infection;
injuries;
vascular disorders;
tumors, etc.

The disease is manifested by the following symptoms: attacks of pain of a varied nature, which do not always coincide with the zone of innervation of the nerve. When the disease occurs, damage can occur to either individual branches or the entire nerve. The severity of neuropathy depends on the form of the disease. With a mild form, the disease is practically not a concern. In severe forms, attacks cause a lot of suffering.

Diagnosis of diseases

The following instrumental research methods are used:
MRI of the brain, neck and face tissues. On MR tomograms, the centers of the trigeminal nerve, its exit areas and blood vessels are clearly visible;
Electromyography helps to study conduction nerve impulse along nerve fibers;
An orthopantogram allows you to determine the causes of damage to the jaw branches of the nerve.

Nerve transplantation

Treatment and prevention

Drug treatment takes a leading place in many nerve diseases. Among the most effective drugs finlepsin ( synonym carbamazepine), prescribed in tablet form. The course of treatment is designed for a long time. Under the supervision of a doctor, the dosage of the drug is increased or decreased. Independent, uncontrolled increase in dose medicine fraught undesirable consequences in the form of disruption of the liver and kidneys. In addition, painkillers are prescribed. If conservative treatment is not effective, then a neurosurgical operation is prescribed - microvascular decompression. The purpose of this operation is to install a Teflon protector between the nerve and the vessel in order to eliminate pathological impulses.

For neuralgia or neuritis, blockades are performed to relieve attacks of severe pain. First, painful points are determined, into which a solution of local anesthetic is injected ( novocaine). Diseases cannot be treated with blockades, since they only provide temporary pain relief.

IN folk medicine There are many recipes used that help eliminate pain. Proven folk recipes:
plucked geranium leaves should be applied to the sore spot and wrapped in a downy scarf. The pain will soon begin to subside;
drink a quarter glass 3 times a day of warm chamomile decoction, etc.
During remission, massage is indicated, in which the main techniques are stroking, rubbing and vibration.
Disease prevention is closely related to in a healthy way life, as well as with a warning chronic diseases sinuses of the nasopharynx, teeth. It is important to treat on time colds in the acute stage.

The trigeminal nerve is the fifth of twelve pairs cranial nerves and consists of three branches that innervate areas of the face and neck. According to international classification diseases include trigeminal neuralgia, atypical facial pain and lesions of unspecified etiology. Treatment of these diseases is possible with the help of traditional medicine and folk remedies.

Structure and function of nerve fiber

The trigeminal nerve is mixed in structure. This means that it contains motor and sensory fibers. In addition to them, the nerve ganglion fits a small amount of secretory fibers. They are responsible for the functioning of the exocrine glands.

The trigeminal nerve enters the surface of the brain from the lateral part of the pons, passes through the thickness of the pons and forms the trigeminal ganglion in the middle cerebral fossa. Three main branches emerge from this thickening: n. ophthalmicus, n. maxillaris and n. mandibullaris. This anatomical feature is key to understanding the pathogenesis of pain in a particular innervated area.

Diseases

The main diseases of the trigeminal nerve are neuralgia and neuritis. They differ in etiological factor, but clinical manifestations they are very similar.

Trigeminal neuralgia is an increase in sensitivity in the innervation zones. Its pathogenesis has not been fully studied, and the most common etiological factors include pinching in the area of ​​the trigeminal node and malnutrition due to atherosclerotic changes. Compression may be caused by a neuroma or result from trauma.

Trigeminal neuritis is a disease with an inflammatory etiology. This includes the herpes simplex virus, past infectious diseases, the pathogens of which are tropic to nerve tissue. It is also important to note the local and general hypothermia, mental stress, any foci of infection in the body. At improper treatment Using folk remedies, neuritis can become chronic.

The symptoms of these two diseases are very similar. This is pain along the nerve fibers and loss of function. The location of these symptoms depends on which branch or part of the nerve is affected, so knowledge of anatomy is important for correct diagnosis.

• If the orbital branch is damaged, the patient complains of impaired sensitivity in the innervated areas, namely: the skin of the forehead, the back of the nose, upper eyelid and the inner corner of the eye. On examination, dry mucous membranes of the eyes and nose are noted. The neurologist may notice a decrease in the superciliary and corneal reflexes;
• When the second (maxillary) branch is affected, the patient notes decreased sensitivity and pain in the lower eyelid, outer corner of the eye, lateral surface of the face, upper cheek, upper jaw and upper row of teeth. With neuralgia, pain can be triggered by shaving or brushing teeth;
• Damage to the third branch is accompanied not only by impaired pain and tactile sensitivity, but also by a decrease in the function of the glands. Such symptoms are associated with damage to secretory fibers. The patient also notes paralysis of the masticatory muscles and difficulty swallowing.

Symptoms can be either unilateral or bilateral. This is explained different character defeats nerve fiber and etiology of the disease.

Diagnostics

In order to correctly determine the affected area, you need to not only focus on the patient’s complaints, but also a thorough neurological examination. The trigeminal nerve can be affected along its entire length, so it is important to identify the point of localization of the pathological process.

The doctor examines the exit points of the trigeminal nerve to the surface for pain and discomfort. To do this, the doctor runs his finger along the brow ridge, palpates the projection of the “dog fossa” and the dimple on the chin. All these places correspond to the exit points of the three branches of the 5th pair of cranial nerves and are called Balle's points.

If it is not a separate branch that is affected, but part of the trigeminal nucleus, then the doctor should check the sensitivity and pain in the Zelder zones. They have a head start of brackets and each of them corresponds to a specific nucleus in the thickness of the brain. In these zones the temperature and pain sensitivity, i.e. superficial, and deep remains intact. This is used to differentiate the source of damage.

Sensitivity testing is carried out using a neurological hammer with a blunt needle at the end. The doctor checks her with slight tingling according to the segmental type.

Movement disorders can be identified due to asymmetry of the lower jaw. The range of movement may be different on both sides. Palpation of the muscles may reveal atrophy or excessive sensitivity.

TO instrumental methods examinations include skull radiography and MRI.

Therapy methods

Treatment of the trigeminal nerve depends on etiological factor. If a pathogen is present, the doctor prescribes etiotropic treatment (antibiotics, antifungals or antiviral drugs). Long-term use of acyclovir is indicated for the treatment of neuritis caused by the herpes virus.

To relieve pain, various medications are prescribed: from non-steroidal anti-inflammatory drugs to narcotic analgesics in case of an unresolved attack.

Pain can also be relieved using folk remedies. The most common and well-known recipes include bags of sand, salt or any cereal heated in a frying pan. Dry heat helps reduce pain symptom. If the second and third branches are affected, it is useful to use chamomile decoction as a folk remedy, which should be held in the mouth before drinking. It has a weak anti-inflammatory effect.

Warm water can be used as a compress. fir oil. Folk remedies are used in cases where traditional therapy is not recommended.

In the conservative treatment regimen for trigeminal neuralgia, anticonvulsants are successfully used in small doses. Antispasmodics and muscle relaxants are also prescribed to relieve pain symptoms.