Other Cranial Neuralgias

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GLOSSOPHARYNGEAL NEURALGIA

This is a very rare condition that is sometimes confused with trigeminal neuralgia. The pain is of an identical nature, but it affects a different area. Glossopharyngeal neuralgia is usually felt at the base of the tongue, the back of the throat and may radiate to the ear. It affects only one side. The same areas become hypersensitive and the pain can be triggered by touching the ear or swallowing.
 

NERVUS INTERMEDIUS or GENICULATE NEURALGIA

Nervus intermedius neuralgia sometimes known as or Geniculate Neuralgia is an extremely uncommon pain syndrome in which the patient reports shock-like pains in the distribution of the nervus intermedius, which is the somatic sensory branch of cranial nerve VII. The pain is in every way similar to that of tic douloureux except for its location.
 

VAGAL or SUPERIOR LARYNGEAL NEURALGIA

Vagus nerve neuralgia is characterized by paroxysms of shock-like pain in the side of the throid cartilage, pyriform sinus, angle of the jaw, and, rarely, in the ear. Occasionally the pain radiates into the upper thorax or up into the jaw. The trigger zone is usually in the larynx; attacks are precipitated by talking, swallowing, yawning, or coughing. When other portions of the vagus nerve are involved, the patient might have hiccups, inspiratory stridor, excessive salivation, or coughing. The pain is in every way typical of tic douloureux except for its location. The combination of glossopharyngeal and vagal as well as trigeminal pain has been reported.
 

SPHENOPALATINE NEURALGIA (VIDIAN NEURALGIA)

A distinctive syndrome of headaches, better known today as cluster headache. There are two main clinical patterns of cluster headache -- the episodic and the chronic:

Episodic: This is the most common pattern of cluster headache. It is characterized by 1-3 short attacks of pain around the eyes per day, with these attacks clustered over a stretch of 1-2 months followed by a pain-free remission, a breathing spell. The average length of remission is a year. 

Chronic: Characterized by the absence of sustained periods of remission, chronic cluster headache may start with no past history of cluster headaches, or it may emerge several years after the patient has experienced an episodic pattern of cluster headaches.
 

OCCIPITAL NEURALGIA

Occipital neuralgia, also known as C2 neuralgia, Arnold's neuralgia, is a medical condition characterized by chronic pain in the upper neck, back of the head and behind the eyes. These areas correspond to the locations of the lesser and greater occipital nerves. The symptom of this condition is chronic headache. The pain is commonly localized in the back of head and around or over the top of the head, sometimes up to the eyebrow or behind the eye. Because chronic headaches are a common symptom for numerous conditions, occipital neuralgia is often misdiagnosed at first, most commonly as tension headache or a migraine leading to treatment failure or addiction. Another symptom is the eyes being sensitive to light, especially when headaches occur. 
 

CERVICOGENIC HEADACHE AND OTHERS

Cervicogenic headache, which is clinically defined as pain that is present in the head, but which originates in the cervical spine.

Cervicogenic headaches, like other types of headaches are different for different people; some are more severe, some present in the head while others have pain behind the eyes.

Post-Herpetic Neuralgia

Postherpetic neuralgia (PHN) is a neuralgia caused by the varicella zoster virus. Typically, the neuralgia is confined to a dermatomic area of the skin and follows an outbreak of herpes zoster (HZ, commonly known as shingles) in that same dermatomic area. The neuralgia typically begins when the HZ vesicles have crusted over and begun to heal, but it can begin in the absence of HZ, in which case zoster sine herpete is presumed (see Herpes zoster).

Treatment options for PHN include antidepressants, anticonvulsants (such as gabapentin or pregabalin) and topical agents such as lidocaine patches or capsaicin lotion. Opioid analgesics may also be appropriate in many situations. There are some sporadically successful experimental treatments, such as rhizotomy (severing or damaging the affected nerve to relieve pain), and TENS (a type of electrical pulse therapy).

Pain due to Tumours of the Head and Neck