The pain of neuralgia is described as intense, sharp, stabbing, burning, or electric like.It is typically unilateral. The trigeminal and glossopharyngeal cranial nerves are most frequently involved in paroxysmal neuralgia of the orofacial region.Its duration may be from a few seconds to minutes, and there may be a refractory period between attacks. Neuralgic pain is episodic. Attacks may occur for a few weeks or months and then enter a period of remission, which may last months or years.

Greater Occipital Entrapment Neuropathy
It is a potential source for head pain. Inflammation or entrapment of this nerve results in referral of moderate to severe frontal headache, which may simulate migraine headache. It may be relieved by anesthetic block.

Trigeminal Neuralgla
It was first discribed by John Locke in 1677. It is commonly referred to as tic douloureux,It is a paroxysmal facial pain disorder that occurs unilaterally in the distribution of the trigeminal nerve. It usually begins after age 40 and involves women more than men in a 3:2 ratio. The mandibular division is most frequently involved followed by the maxillary division.

  • Majority of cases are idiopathic.
  • Compression of root of trigeminal nerve due to pathological lesions.

Glossopharyngeal Neuralgias
It is a rare condition that occurs in its somatosensory branches and the vagus nerve. Men and women are equally represented. The pain of glossopharyngeal neuralgia is felt in the ear, pharynx, tonsil, and retromandibular areas. Although similar in quality to trigeminal neuralgia, it may not be as severe and cutaneous, and mucosal trigger points are rare. Chewing, talking, and swallowing, especially cold liquids, may precipitate the pain.

Medical Treatment
Many drugs like Baclofen, Carbamazepine, Phenytoin, Chlorphenesin, Tizanidine, etc. are used for treatment for neuralgia.

Destructive Procedures
A.Injection of Alcohal,Hot water,Phenol in wax or glycerene along the Trigeminal Nerve pathway, or Gasserian Ganglion produces releif in pain.

Surgical Treatment(Peripheral Neurectomy)
Between 25 to 50 percent of patients eventually fail on drug therapy and need neurosurgical treatment like Local Avulsion of peripheral nerves and wide section of sensory roots of the trigeminal nerves.

Radio Frequency Rhizotomy(Thermocoagulation)
It is done placing an electrode under radiographic control in the root of trigeminal nerve MicroVascular Compression is done by compressing the trigeminal root closed by the brain stem. For this a formal craniotomy is required.