Updating Assessment Of Neuralgia With Special Emphasis On Cranial Neuralgia

Abstract

Neuralgia was defined according to Borland's Illustrated Medical Dictionary (1988) as a paroxysmal pain extending along the course of one or more nerves. This definition was modified in the next edition of that dictionary in 1994 to be: Neuralgia is a pain extending along the course of one or more nerves. Neuralgia is a disabling disease, different types are identified e g. trigeminal, glossopharyngeal, and post-herpetic neuralgia. Penman (1988) estimated a prevalence of trigeminal neuralgia per 1 million population as 107.5 and 200.2 for men and women, respectively (Terrence et al, 2000% The pathophysiology of neuralgia has been much disputed. Most observers have failed to find clinical changes in sensation in the affected area. However Lewy and Grant,(1938)7 maintained that there is a change in the tactile and thermal thresholds in neuralgia. Bowsher et aL, (1977) decided to reinvestigate the problem using sophisticated quantitative sensory perception threshold tests in patients presenting tor relief of neuralgia by micro-vascular decompression. Dandy (1934 ) first observed the association of vascular abnormalities impinging on the trigeminal dorsal root in cases of trigeminal neuralgia.Other surgical series confirm these findings, and lend support to the hypothesis that vascular compression is the primary cause of trigeminal neuralgia. Whether or not to recommend microvascular decompression versus a