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Saturday, 30 November 2013

Neuralgia - The Diagnosis and The Do's and Do not's list

Neuralgia is defined as a condition of a sudden and heavy attacks of pain that follows the path of a nerve or nerves as a result of a change in neurological structure or function due to irritation or damage to the nerves without stimulating pain receptor (nociceptor) cells. the disease affects about 2%–3% of the population.

III. Diagnosis
Diagnosis of neuralgia is difficult, and misdiagnosis is common. Assessment of the patient with suspected neuropathic pain should focus on ruling out treatable conditions (e.g., spinal cord compression, neoplasm), confirming the diagnosis of neuropathic pain and identifying clinical features (e.g., insomnia, autonomic neuropathy) that might help individualize treatment. Box 1 lists principal details of the clinical evaluation, including history, physical examination and special tests.Diagnosis typically involves locating the damaged nerve by stimulation of the specific damaged pathway or by identifying missing sensory function(18)


IV. Preventions
A. The Do's and Do not's list 
1. Reduce unhealthy fat and increase intake of n-3 series polyunsaturated fatty acids
Both basic and clinical studies have shown that a dietary intake of n-3 series polyunsaturated fatty acids results in a reduction in the pain associated with rheumatoid arthritis, dysmenorrhea, inflammatory bowl disease, and neuropathy, Dr Tokuyama S and Dr. Nakamoto K. at the Kobe Gakuin University indicated(19).


2. Avoid infection
The best way to avoid infection caused by bacteria and virus is to enhance the immune system, people with weakened immune system such as chronic illness, aging, etc. are at increased risk infectious causes of neuralgia. There are suggestion that Innate immune cells play a central role in inflammation and are thus critical for the pathogenesis of inflammatory diseases(20)

3. Eating healthy with balance diet
Preferred eating certain kinds of food cam increase the risk of nutrients deficiency of that can trigger  Neuralgia  as we mention in (B.3.)


4. Moderate drinking
Excessive alcohol drinking can cause Neuralgia. Three cases of jaw pain recurrently precipitated by consumption of alcohol are described. Alcohol-induced neuralgia is added to the differential diagnosis of atypical orofacial pain(21).

5. Smoking
Dr. Parruti G and the team at the Infectious Disease Unit, Pescara General Hospital showed in one of the study that Smoking, traumas and surgery at the HZ site emerged as new predictors of both HZ-related pain intensity and persistence, opening new perspectives in the prevention of HZ-related pain. An independent line of evidence was provided for the efficacy of antiviral therapy in preventing PHN and reducing total pain burden(22)

6. Eat your fruits and vegetables
Fruits and vegetables contain high amounts antioxidants which can enhance the immune system in fighting against the forming of free radicals and foreign invasion such as viral and bacterial causes of infection.

7.  Etc.
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Sources
(18) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1513412/?tool=pmcentrez 
(19) http://www.franksherwood.com/mytalk.htm 
(20) http://www.ncbi.nlm.nih.gov/pubmed/22127030
(21) http://www.ncbi.nlm.nih.gov/pubmed/3458800  
(22) http://www.ncbi.nlm.nih.gov/pubmed/20937086