Cranial Neuralgias.

Area of Science:

• Neurology
• Neuroscience
• Pain Medicine

Background:

• Cranial neuralgias represent a substantial health burden.
• Accurate diagnosis is crucial for successful treatment, requiring expertise in neuroanatomy, pathophysiology, and clinical presentations.
• This review focuses on primary and secondary cranial neuralgias.

Purpose of the Study:

• To delineate the relevant anatomy, clinical features, and management of common and rare cranial neuralgias.
• To provide an overview of trigeminal neuralgia, herpes zoster virus-related neuralgias, and rarer facial pain syndromes.
• To guide clinicians in diagnosing and managing patients with cranial neuralgias.

Main Methods:

• Review of relevant literature on cranial neuralgias.
• Delineation of neuroanatomy and pathophysiology.
• Discussion of clinical features and management strategies.

Main Results:

• Trigeminal neuralgia, a severe facial pain, can stem from neurovascular compression or demyelination.
• Herpes zoster virus is a frequent cause, leading to acute herpes zoster ophthalmicus and chronic postherpetic neuralgia.
• Rarer syndromes include glossopharyngeal neuralgia, nervus intermedius neuralgia, and paratrigeminal oculosympathetic syndrome.

Conclusions:

• Cranial imaging is recommended for patients with unexplained cranial neuralgia to detect structural abnormalities like neoplasms or vascular malformations.
• Management of cranial neuralgias, both common and rare, presents challenges.
• Evidence-based guidance is essential for optimal patient care.