Cranial Neuralgias

Neuralgije kranijalnih živaca stanja su koja se odnose na mjesto boli u području lica i glave. Uzrok boli jest podražaj osjetnoga živčanog tkiva u tom području. Također poznata kao neuropatska ili neurogena bol, neuralgija nastaje kao posljedica strukturnog i funkcionalnog poremećaja u perifernom ili središnjem živčanom sustavu. Opisani poremećaji mogu biti uzrokovani infekcijom, traumom, biti posljedica metaboličkih odstupanja, kemoterapije, operacije, zračenja, oštećenja neurotoksinima, kompresije, upale ili infiltracije tumora. Tipične osobine boli koja je posljedica kranijalne neuralgije opisane su kao električni šok ili žareća i paleća bol. Pojavljuje se gotovo uvijek jednostrano, ali se u 3 do 5% slučajeva može javiti i bilateralno. Pacijenti mogu imati razdoblje bez boli ili pojavu blage parestezije (trnaca) nakon napadaja. Postoje dvije kategorije kranijalnih neuralgija: one koje imaju epizodne simptome i one kod kojih su simptomi prisutni kontinuirano. Epizodni ili paroksizmalni napadaji traju od sekunde do nekoliko minuta, a mogu biti česti ili razdvojeni dugim razdobljima remisije. Često postoji događaj koji pokreće proces boli kao što je površan, nježan dodir lica ili usta. Neke pacijente bol onesposobljava, uz razvoj anksioznosti i/ili depresije. Što prije liječenje ključno je za poboljšanje kvalitete života pacijenta, a time i za bolju prognozu.Cranial neuralgias are conditions referring to pain that occurs in the facial and head area. The pain is caused by the stimulation of the sensory nerve tissue inside that area. Also known as neuropathic or neurogenic pain, neuralgia is induced by a structural and functional disorder in the peripheral or central nervous system. The described disorders may be caused by an infection and trauma or may result from metabolic disorders, chemotherapy, surgery, radiation, damage caused by neurotoxins, compression, inflammation or tumour infiltration. Pain resulting from cranial neuralgia is typically described as pain similar to electric shock sensation or as lancinating and burning pain. It is almost always unilateral, although it may occur as bilateral pain in about 3% to 5% of the cases. Patients may have a period without pain or may experience mild symptoms of paraesthesia (a sensation known as “pins and needles”) following a seizure. There are two categories of cranial neuralgias: those with episodic symptoms and those with continuous symptoms. The episodic or paroxysmal seizures last from a second to a few minutes, and may be frequent or occur between long periods of remission. There is often an event that triggers the pain, such as a slight, gentle touching of face or mouth. For some patients, the pain is excruciating and incapacitating, causing the development of anxiety and/or depression. Early treatment is crucial for the improvement of patient’s quality of life; the sooner the neuralgia is treated, the better the prognosis