What is trigeminal neuralgia and what is the disease code for ICD 10?

1 Characteristics of the development of the pathology

Neuralgia of the trigeminal nerve, which is listed in the International Classification of Diseases( ICD) 10 under the code G50.0, is a rather specific condition, and there has been no consensus on the causes of this pathological condition in the medical community for a long time. At present, much is known about the causes and predisposing factors of the development of such a dangerous neurological disease as trigeminal neuralgia. Such factors include:

• congenital narrowness of the bony canals;
• total supercooling;
• is a tumor and a person's hematoma;
• multiple sclerosis;
• herpes zoster;
• fractures of the bones of the facial skull;
• viral infections that affect the nerves;
• destruction of the trigeminal nerve sheath of any etiology;
• close nerve location to blood vessels.

Often, the triggers of neuralgia include strokes and injuries, which usually lead to this condition for the first time. In the future, even any wind blow or other contact with the skin of the face can provoke acute attacks. In some patients, the first manifestations of neuralgia are observed against the background of an unsuccessfully removed tooth, as well as an acute course of infectious diseases of the oral cavity. In rare cases, the development of neuralgia of the trigeminal nerve can be associated with the progression of cervical osteochondrosis.

2 Symptoms of the disease

The most vivid manifestation of the neuralgia of the ternary nerve are the strongest pain attacks in the face, which, as a rule, are not accompanied by the patient's cry only because any jaw movements significantly aggravate the situation. Against the background of a pain attack, other vegetative manifestations of neuralgia can also be observed, including lacrimation or discharge of mucus from the nose, profuse sweating and even fever. Among other things, during an attack there is a spasm of facial muscles, which leads to the appearance of a significant asymmetry of the face and its painful expression. Many patients tend to touch the face at the time of an attack, which can provoke a repeated attack of pain.

An intensive pain syndrome can be observed for several seconds or even minutes. In periods between attacks, a person may have the strongest fear. Many people, fearing a new attack, try not to touch one another again, and also do not brush their teeth, do not shave and do not even wash. Such fear greatly complicates a person's life. In addition, with a prolonged course of trigeminal neuralgia leads to a change in the sensitivity level of the soft tissues of the face. First, there is a significant increase in the sensitivity of half the face. Further, there is a decrease in sensitivity up to numbness.

3 Diagnosis and treatment actions

As a rule, it is enough for the doctor to hear the patient's complaint for the diagnosis. With a neurologic examination of the patient, special attention is paid to reducing the corneal reflex on the affected side, the presence of trigger zones that can trigger trismus, and even the change in the sensitivity of the skin.

In addition, to confirm the diagnosis, it is possible to carry out MSCT or MRI to examine the brain in order to exclude the presence of malignant tumors in its tissues.

During the diagnosis in the medical history, the location of the anomaly area along the branches is indicated, as well as the stages of the disease course, that is, the duration of exacerbations and remissions, the frequency of seizures, expressed sensitive disorders and pain sensations. This is extremely important for detecting the extent of damage to nerve tissues and determining the optimal therapy option. Treatment can be medicated, physiotherapeutic and even surgical methods. As a drug treatment, as a rule, drugs are assigned to the following groups:

• anticonvulsants;
• antiepileptic drugs;
• normotry;
• nootropics;
• antihistamines;
• stimulators of hemopoiesis;
• vitamin complexes.

In most cases, the same drugs are used as in a condition such as neuralgia of the occipital nerve. As a physiotherapy, as a rule, electrophoresis with novocaine is performed, but other procedures can be used to help eliminate pain and neuralgia.

The most effective way to eliminate neuralgia of the trigeminal nerve can be called surgical intervention, but such operations are quite traumatic and can lead to serious complications in case of nerve damage. Modern methods of surgical treatment of neuralgia have stepped far ahead, therefore the whole procedure, as a rule, is painless. There are several types of operations for the treatment of neuralgia. In a number of cases, novocain blockades are contemplated, involving the administration of novocain and exerytic nerve roots.