[Pathophysiology of facial neuralgia (authors' transl)]

Facial neuralgia appears in a variety of forms which have different fundamental pathophysiological mechanisms. Of decisive importance are neuralgias with sensitive trigeminal, intermediate (sensory root), glossopharyngeal and vagus nerves which are caused by functional disturbances or damage to the nerve. In addition, projected or referred pain occurs in intracranial and cervical affections. A vascular origin may be assumed for Horton's neuralgia. This periodic paroxysmal and unilateral facial neuralgia is related to migraine. Serotonin, histamine and plasma kinin may be important eliciting factors; the concomitant symptoms of lachyrmation and rhinorrhea, reddening of the eyes and the face and a transitory Horner's syndrome suggest participation of the sympathetic and parasympathetic systems. Consideration of the previously known pathophysiological mechanisms permits a differentiated therapy for the various facial neuralgias.