Headaches due to Neuralgia or Neuritis are severe types of intermittent pain, which are localized in the area of the affected nerve.
These conditions include trigeminal neuralgia and other conditions.
Trigeminal neuralgia is a pathological condition for which no specific cause has been established. The headache is unilateral, very intense, and recurrent, affecting the facial region.
Trigeminal neuralgia triggers pain which begins above the ear and later spreads to the entire cheek. It is a sharp, burning type of pain.
The pain can be triggered by:
The pain is intermittent, can last for approximately 30 seconds, followed by a free-pain period that may reoccur for a few hours at a time.
The attacks can go for weeks or months. Attacks may at times also spontaneously subside.
Trigeminal neuralgia usually affects one side of the face. In rare cases, it can affect both sides, although not at the same time.
The pain can be:
However, in severe cases of trigeminal neuralgia attacks may occur hundreds of times a day and there may be no periods of remission.
Medical Treatment and their benefits
Medical treatment is aimed at reducing attack frequency and severity over time and is effective for approximately 70% to 80% of patients with classical Trigeminal Neuralgia.
Carbamazepine have demonstrated efficacy with 58% to 100% of patients achieving near-complete pain control and treatment response beginning as soon as 2 days after initiation.
Other RCTs have shown probable efficacy of oxcarbazepine and possible effectiveness of baclofen and lamotrigine.
Additionally, smaller studies suggest that gabapentin, valproate, and levetiracetam, as well as phenytoin and tizanidine (although both with rapidly diminishing effects over time), may have benefit in Trigeminal Neuralgia.
Type 2 Trigeminal Neuralgia
This type is less likely to respond to any of the aforementioned treatments. OnabotulinumtoxinA injected to the affected skin or mucosal region, has also been recently shown to be effective in reducing pain severity and attack frequency in a double-blind, saline injection placebo-controlled trial, although side effects included facial asymmetry lasting up to 7 weeks.
If medical therapy fails or is poorly tolerated, interventional treatments can be considered.
Finally, percutaneous procedures on the Gasserian ganglion, or rhizotomies, involve:
In a few studies using independent outcome measures, pain freedom was attained in 90% of patients immediately following rhizotomy, but dropped to 54% to 64% after 3 years.
Adverse effects are frequent, with sensory loss occurring in almost half of cases, dysesthesias in 6%, masticatory difficulties in up to 50%, and anesthesia dolorosa, or painful numbness that can develop 3 to 6 months after the procedure, in about 4%.
Sinus headaches are usually associated with constant pain and tenderness over the affected sinus. You may feel pressure around eyes, cheeks and forehead. The mucosa of the nose swells, the patient secretes foul-smelling, colored mucous (nasal discharge).
Headaches are one of the most common health complaints, but most aren't serious and are easily treated. In many cases, you can treat your headaches at home with over-the-counter painkillers and lifestyle changes, such as getting more rest and drinking enough fluids.
Headaches are an important public health issue that impact the lives of a significant of the world’s population, affecting patients with severe pain, nausea and sometimes visual impairment. Common headache types include tension headaches, cluster headaches, rebound headaches, sinus headache, and migraine.
Vascular headaches refer to a group of headache conditions such as migraine headaches, cluster headaches and toxic headaches. Under this classification are usually headaches throbbing in character, pulsating and physical exertion increasing the pain.
A migraine is characterized as an intermittent pulsative pain on one side of the head. While migraine is a fairly common symptom, which affects women more so than men. The onset of migraines usually occurs in early adulthood, and rarely after 40 years of age. Migraines may be accompanied by symptoms such as; Photosensitivity, Enhanced sensitivity to sound, Nausea, Vomiting.
These headaches are usually felt in the back of the head (occipital region). Patients may experience also headaches when they undergo hypertension treatment. Some of the medications used to treat hypertension can cause headaches.
Intracranial hypertension (IH) is the medical name for a build-up of pressure around the brain. It can come on suddenly for example, as the result of a severe head injury, stroke, or brain abscess. One of the most common symptoms of intracranial hypertension is headache. The cause of intracranial hypertension is unknown.
Rebound Headaches are a type of headaches caused by long term use of analgesic agents. These analgesics may decrease the intensity of pain for a few hours. The rebound headache may feel like a dull, tension-type headache or a more severe migraine like headache.
Headaches due to Neuralgia or Neuritis are severe types of intermittent pain, which are localized in the area of the affected nerve. These conditions include trigeminal neuralgia and other conditions.
Morbus Horton is a vascular disease characterized by the inflammation of blood vessels. The intensity of pain is mild. The pain is located in the temporal region and the vessels in that area can be tender.
Many acute viral infections can cause headache as a response of the immune system combating the viral infection. Headache may be associated with viral infections that affect the upper respiratory tract (common cold), brain and its coverings (encephalitis and meningitis) or ear (otitis).
Usually this is a type of short, bursting, stabbing pain felt in the part of the head which bears the infected ear. The diagnosis is usually determined upon an examination of the ear by a specialist.
Headache due to Toxic Substances are headaches that may be caused by carbon monoxide poisoning, benzol, nitroglycerine, etc. This type of headache may also be experienced if the patient is suffering from conditions such as, kidney disease, diabetes, metabolic conditions, etc.
Following a lumbar puncture, the patient may develop a headache. This type of pain may be bearable, moderate or severe. It may spread from the head to the neck, and further down the patientÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢s back. This type of pain is alleviated when the patient lies down, or puts their feet up.
This type of pain occurs during the night or early in the morning. The headache can be an early or late symptom of a brain tumor, depending from the location of the tumor. Most brain tumors are accompanied by neurological symptoms such as; seizures, personality change or weakness.
These headaches occur as a result of an inflammatory process, like for example Meningitis (inflammation of the meninges, lining layers of the brain) or due to another condition such as a sub-arachnoid hemorrhage. Diagnosis is confirmed via lumbar puncture.
These are types of headaches which occur more rarely. These are headaches caused by dental conditions. The pain is not throbbing nor is it intermittent.