Causes

• There are many causes for neuralgia the list of most important causes are
• Diabetes
• Drugs
• Chemical irritation
• Chronic renal insufficiency
• Infections, such as shingles, syphilis, and Lyme disease
• Pressure on nerves by nearby structures (for instance, tumors)
• Swelling (inflammation)
• Trauma (including surgery)
• Trigeminal neuralgia is the most common form of neuralgia.

 Symptoms

•   Impaired function of affected body part due to pain, or muscle weakness due to motor nerve damage
•   Increased sensitivity of the skin or numbness of the affected skin area .                                    
•   Pain along the path of a specific nerve
•   Pain located anywhere, usually on or near the surface of the body
•   Sharp, stabbing pain that comes and goes (intermittent) or constant, burning pain.

 Exams and Tests

 An exam may show:

 Abnormal sensation in the skin

 Loss of deep tendon reflexes,

 Loss of muscle mass

 Lack of sweating

Tenderness along a nerve,

There are no specific tests for neuralgia, but the following tests may be done to find the cause of the pain

1. Blood tests to check blood sugar and kidney function

2. Magnetic resonance imaging (MRI)

3. Nerve conduction study with electromyography

4. Spinal tap (lumbar puncture)

Treatment

The goal of treatment is to reverse or control the cause of the nerve problem  and provide pain relief. 

Even if the cause of the neuralgia is never identified, the condition may improve on its own or disappear with time.

The cause should be treated

This may include surgery to remove tumors or separate the nerve from blood vessels or other structures that press on it.

Strict control of blood sugar may speed recovery in people with diabetes who develop neuralgia.

Medications to control pain may include:

Antidepressant medications like  amitryptyline , nortriptyline.

Antiseizure  medications like

carbamazepine ,

gabapentin,

lamotrigine for trigeminal neuralgia pain

Mild over-the-counter analgesics acetaminophen, ibuprofen

Narcotic analgesics for short-term relief of severe pain

Topical creams containing capsaicin

Surgical procedures

Ablation using radiofrequency,

Balloon compression, 

Injection to reduce feeling in the nerve.

When other treatment methods fail, may try motor cortex stimulation .

Prognosis

Most neuralgia are not life-threatening disorders. However, pain can be severe. For severe pain, explore all treatment options by consulting a doctor.

Complications

Complications of surgery

Disability caused by pain

Side effects of medications used to control pain

Prevention

Treating related disorders such as diabetes and renal insufficiency may prevent some neuralgias.

Strict control of blood sugar may prevent nerve damage in people with diabetes.