Neuralgia causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Common Causes

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.

Postherpetic Neuralgia

Not all of those diagnosed with shingles go on to experience postherpetic neuralgia, which can be more painful than shingles. The pain and sensitivity can last for months or even years. The pain is usually in the form of an intolerable sensitivity to any touch but especially light touch. Postherpetic neuralgia is not restricted to the face; it can occur anywhere on the body but usually occurs at the location of the shingles rash. Depression is not uncommon due to the pain and social isolation during the illness. Treatment for postherpetic neuralgia is the same as for other forms.

Atypical (trigeminal) Neuralgia

The symptoms of atypical neuralgia (ATN) tend to be vague and misleading. This may be the most misdiagnosed form of neuralgia. The symptoms can be mistaken for migraines, dental problems such as TMJ, musculoskeletal issues, and hypochondriasis. This form of neuralgia is extremely rare, thus also contributing to the misdiagnosis. ATN can have a wide range of symptoms and the pain can fluctuate in intensity from mild aching to a crushing or burning sensation, and also to the extreme pain experienced with the more common trigeminal neuralgia.

The pain from ATN is usually less than that of trigeminal neuralgia, but is nearly continuous and periods of remission are rare. This form can also cause pain in the back of the scalp and neck.

Many attempts have been made to link ATN with psychological issues, though modern studies have shown no link. Theories have suggested that infections of the teeth or sinuses, vascular compression, physical trauma, or past viral infections could be a cause. Evidence thus far seems to be anecdotal. Another interesting aspect is that this form affects men and women equally, unlike the trigeminal neuralgia, which is much more common in women than men.

ATN is also known as Atypical Facial Pain (ATP) or Persistent Idiopathic Facial Pain (PIFP).

Causes of Neuralgia in Alphabetical Order

  • Chemical irritation
  • Chronic renal insufficiency
  • Diabetes
  • Drugs
  • Infections, such as herpes zoster ( shingles), HIV, Lyme disease, and syphilis
  • Medications such as Enfuvirtide, cisplatin, paclitaxel, or vincristine, leflunomide, oxcarbazepine, pentamidine Isethionate
  • Porphyria
  • Pressure on nerves by nearby bones, ligaments, blood vessels, or tumors
  • Trauma (including surgery)


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