Cranial nerve disorder

The cranial nerves include the trigeminal nerve, the glossopharyngeal nerve, and the facial nerve.

Trigeminal neuralgia (TN)

The trigeminal nerve is the main nerve that provides facial sensitivity - superficial - pain and tactile, deep - proprioceptive. TN is most often found in women aged 50-69 and has a right-sided lateralization. The development of the disease is facilitated by various vascular, endocrine-metabolic, allergic disorders, as well as psychogenic factors. TN is considered an idiopathic disease. However, there are several theories explaining the pathogenesis of the disease. The most likely cause of TN is compression of the trigeminal nerve inside - or outside - the skull. Compression can be caused by tumors, adhesions after injuries, infections, but most often - dislocation and expansion of the tortuous cerebellar arteries, veins. Another possible cause is an aneurysm of the basilar artery.

Among the extracranial factors are:

  • formation of tunnel syndrome (compression of the 2nd and 3rd branches in the bone canals - the infraorbital foramen and the lower jaw with their congenital narrowness and the addition of vascular diseases in old age);
  • as a result of a local odonto- or rhinogenic inflammatory process.

The disease can develop after tooth extraction (the alveolar nerve is affected) - odontogenic neuralgia, as a result of circulatory disorders in the brainstem, as a result of a herpes infection, rarely due to demyelination of the trigeminal nerve root in multiple sclerosis.

Symptoms:

  • Pain in the facial area occurs suddenly, the duration of the attack reaches several seconds
  • The pain can be severe, shooting and resemble an electric shock
  • The pain can suddenly occur after touching the face, while chewing, talking or brushing teeth
  • The pain spreads to the areas of the face that are innervated by the trigeminal nerve - the lower jaw, cheek, gums, lips, sometimes the eye or forehead
  • The pain is accompanied by vegetative reactions - lacrimation, hypersalivation (uncontrolled salivation), hyperemia (redness).
  • If the mandibular branch of the trigeminal nerve is affected, motor disorders in the masticatory muscles are possible - twitching, spasms, atrophy.

Glossopharyngeal neuralgia

Glossopharyngeal neuralgia is quite rare - the attack begins with pain in the throat and spreads to the ear and lower jaw. This disease also has trigger zones - deep in the mouth, in the area of ​​the root of the tongue, tonsils.