Neuralgia

• A
• B
• C
• D
• E
• F
• G
• H
• I
• J
• K
• L
• M
• N
• O
• P
• Q
• R
• S
• T
• U
• V
• W
• X
• Y
• Z

Central nervous system

Nerve pain; Postherpetic neuralgia

• Pain located anywhere, usually on or near the surface of the body
  • In the same location for each episode
  • Sharp, stabbing pain or constant, burning pain
• Pain along the path of a specific nerve
• Impaired function of affected body part due to pain, or muscle weakness due to motor nerve damage.
• Increased sensitivity of the skin or numbness of the affected skin area (feeling similar to a local anesthetic, such as a Novocaine shot)

Any touch or pressure is interpreted as pain. Movement may also be painful.

Neurologic examination shows tenderness occurring along a nerve tract. Trigeminal neuralgia usually causes pain along the second and third nerve divisions (lower face and jaw), and rarely involves the first nerve division (temple and forehead). Other signs of altered nerve function may be seen often, such as loss of deep tendon reflexes, local loss of muscle bulk, local lack of sweating (sweating is regulated by nerve function), and abnormal skin sensation.

There may be specific trigger points (areas where even a slight touch triggers pain). A dental examination is used to rule out dental disorders that may cause facial pain. The presence of other symptoms (such as redness or swelling) may indicate disorders causing the pain, such as infections, bone fractures, rheumatoid arthritis, or other disorders.

No tests are specific for neuralgia, but tests may be used to rule out other causes of the pain. Sometimes a nerve conduction study with electromyography (NCS/EMG), which examines the electrical activity of nerves, may confirm the diagnosis.

The first part of the test, the NCS, involves giving small electric shocks to skin areas overlaying specific nerve paths. The physician then determines whether the conduction of electricity is delayed or blocked through the particular nerve that was tested.

The second part of the test, the EMG, involves the careful insertion of a very fine needle into the skin. The needle is attached to an electric probe. This probe measures the electrical activity of a muscle of interest at rest and during motion. EMG indirectly provides useful clues regarding nerve function. Although the procedure sounds rather unpleasant, most patients are able to tolerate it with little discomfort.