Presentation
Successful treatment depends on accurate diagnosis, which requires knowledge of neuroanatomy and pathophysiology as well as familiarity with the varied clinical presentations encountered in neurologic practice. [ncbi.nlm.nih.gov]
“We know that roughly 52 to 70 percent of patients with relapsing MS have cognitive issues and that these can present very early on,” said Dr. Hotermans. [practicalneurology.com]
The first full account of trigeminal neuralgia was published in 1773 when John Fothergill presented a paper to the Medical Society of London. [medlink.com]
It may also be present behind the eyes, in the upper neck, back of the head, and behind the ears, usually on one side of the head. It usually causes extreme light sensitivity to the eyes. [upmc.com]
Musculoskeletal
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Musculoskeletal Pain
Practical, clinically relevant material facilitates the diagnosis and treatment of musculoskeletal, pain, and chronic disabling conditions. [books.google.com]
Skin
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Flushing
Gk, hemi, half, kranion, skull; L, osus, having a variant of migraine, most common in middle-aged men, characterized by closely spaced episodes of excruciating throbbing unilateral headaches often accompanied by dilation of temporal blood vessels, flushing [medical-dictionary.thefreedictionary.com]
In 1857, John Nottingham introduced the term “tic douloureux of the ear” to describe the sudden paroxysms of pain accompanied by flushing of the auricle. In 1907, Ramsay Hunt noted cutaneous manifestations of patients with herpes zoster of the ear. [medlink.com]
During or following an attack, sufferers may experience tearing, nasal stuffiness or running, facial swelling or flushing, and eyelid edema, all on the affected side. [umanitoba.ca]
Either or both of the following: At least one of the following symptoms or signs, ipsilateral to the headache: Conjunctival injection and/or lacrimation Nasal congestion and/or rhinorrhea Eyelid edema Forehead and facial swelling Forehead and facial flushing [wellmark.com]
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Cutaneous Manifestation
In 1907, Ramsay Hunt noted cutaneous manifestations of patients with herpes zoster of the ear. He described the “zone of Ramsay Hunt” that correlated to the innervation from the nervus intermedius. [medlink.com]
Psychiatrical
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Distractibility
During this phase of the migraine, a person may be unusually sensitive to lights, sounds, and smells and for this reason may choose a quiet, dark, distraction-free environment to rest. Physical activity can often make the pain worse. [brooklynreflexology.com]
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Hunger
Causes : -Chronic muscle tension -TMJ Syndrome -Neck/Jaw trigger points -Psychological or physical stress -Irritation of the cervical spine -Sleep deprivation -Grinding of the teeth (Bruxism) -Injury to the coccyx or sacrum -Hunger Other contributing [brooklynreflexology.com]
Workup
Key points • For several cranial neuralgias, the diagnostic workup should include structural imaging with MRI with and without contrast to evaluate for evidence of inflammation or space-taking lesions, vascular imaging consisting of either MRA or CTA [medlink.com]
Treatment
Pharmacological and alternative treatment modalities are not effective for some individuals, and therefore, other treatment methods have been proposed, such as local injections of anesthetics and/or steroids, epidural steroid injections and ablative treatments [wellmark.com]
[…] of trigeminal neuralgia; tricyclics, pregabalin, opioids, tramadol, and capsaicin for the treatment of postherpetic neuralgia; carbamazepine, gabapentin, lamotrigine, and tricyclics for the treatment of nervus intermedius neuralgia; and nonsteroidal [journals.lww.com]
Some patients choose to combine drug treatment with alternative treatments and complementary techniques including osteopathy, acupuncture, massages and vitamin therapy just to name a few. [headachemd.net]
Overview Symptoms & Diagnosis Treatment What is Occipital Neuralgia? Occipital neuralgia is a distinct type of headache characterized by sudden and recurring jabs of piercing, throbbing, chronic pain. [upmc.com]
Treatment should be guided by the findings. [ncbi.nlm.nih.gov]
Prognosis
Group II is typically a painful postganglionic Homer syndrome with a self-limited course and excellent prognosis ( Salvesen 1999 ). Burning mouth syndrome. [medlink.com]
The prognosis is improved by seeking prompt attention from a physician with specific expertise in the diagnosis and management of head and neck pain. [amentheadachecenter.com]
Cluster Headache: Treatment and Prognosis. Arne May, M.D.. Topic last updated March 15, 2017. UpToDate. Overview of Chronic Daily Headache. Ivan Garza, M.D., Todd J. Schwedt, M.D., MSCI. Topic last updated October 26, 2016. UpToDate. [wellmark.com]
Etiology
Etiology It is usually idiopathic in nature. [practicalpainmanagement.com]
SUMMARY: In patients presenting with a cranial neuralgia, unless the etiology is apparent (eg, herpes zoster), cranial imaging studies should be undertaken to look for structural abnormalities such as neoplasm, granulomatous disease, demyelinating disease [ncbi.nlm.nih.gov]
In patients presenting with a cranial neuralgia, unless the etiology is apparent (eg, herpes zoster), cranial imaging studies should be undertaken to look for structural abnormalities such as neoplasm, granulomatous disease, demyelinating disease, or [journals.lww.com]
TRIGEMINAL NEURALGIA (the 5th Cranial Nerve), HEMIFACIAL SPASM (the 7th Cranial Nerve) and GLOSSOPHARYNGEAL NEURALGIA (the 9th Cranial Nerve) are specific afflictions that share a common underlying pathological etiology (cause). [neurosurgerydallas.com]
The exact etiology is unclear, although it shares histopathological features with idiopathic orbital pseudotumor ( Martinez et al 2010 ). Raeder syndrome. [medlink.com]
Epidemiology
Katusic S, Williams DB, Beard CM et al (1991) Epidemiology and clinical features of idiopathic trigeminal neuralgia and glossopharyngeal neuralgia: similarities and differences. Neuroepidemiology 10:276–281 PubMed CrossRef Google Scholar 3. [link.springer.com]
Epidemiology of occipital neuralgia. Occipital neuralgia is very uncommon, at least as compared to migraine. [dizziness-and-balance.com]
Pathophysiology
Successful treatment depends on accurate diagnosis, which requires knowledge of neuroanatomy and pathophysiology as well as familiarity with the varied clinical presentations encountered in neurologic practice. [ncbi.nlm.nih.gov]
Fromm GH (1991) Pathophysiology of trigeminal neuralgia. In: Fromm GH, Sessle BJ (eds) Trigeminal Neuralgia: current concepts regarding pathogenesis and treatment. Butterworth-Heinemann, Boston, pp 105–130 Google Scholar 43. [link.springer.com]
Since occipital neuralgia is pathophysiologically seen as a cervico-occipito-trigeminal complex, C2 spinal ganglion block therefore is an effective interventional procedure to differentiate the complicated causes of occipital pain including C1-C3 root [pain-manage.org.tw]
So rather than performing destructive procedures such as cutting the nerve which leads to numbness, this new innovative procedure addresses the underlying pathophysiology and removes whatever may be pressing on the C-2 nerve root. [drjho.com]
Prevention
Develop a thorough, clinically relevant understanding of interventions such as physical agents and therapeutic exercise in the prevention, diagnosis, treatment, and rehabilitation of disorders that produce pain, impairment, and disability. [books.google.com]
This will prevent the occipital nerve from transmitting pain signals. RFA can also be applied to the occipital nerve to provide longer lasting pain relief. [ainsworthinstitute.com]
Preventative Treatment of Migraines in Adults. Zahid H. Bajwa M.D. Jonathan H. Smith M.D. Topic last updated May 31, 2017. UpToDate. Tension Type Headaches in Adults: Preventative Treatment. Frederick R. [wellmark.com]
Pharmacotherapy had little success in this condition until Bergouignan s discovery in 1942 that phenytoin was effective in preventing pain paroxysms. [medlink.com]
Both occipital neuralgia and migraine headaches are initially treated with medication in an attempt to reduce symptoms and prevent or alleviate the occurrence of headaches. [advancedreconstruction.com]