Cranial neuralgia

The Headache Classification Committee of the International Headache Society (1988) has developed diagnostic criteria for classification of headache disorders, cranial neuralgias, and facial pain the criteria include painful and nonpainful disorders of the entire head and are based on the diagnosis rather than on the underlying pain mechanisms. 

A major type of headache that must be considered in differential diagnosis is that caused by underlying disease intracranial disturbances (e.g., vascular anomalies, infections, tumors, trauma) diseases involving the head and neck but not the brain (e.g., cervical osteoarthritis disorders of eye, ear, nose, sinuses, and throat cranial neuralgias) and systemic diseases (e.g., sudden and severe hypertension, hyperthyroidism). These headaches usually can be relieved by specific therapy for the underlying disorder (e.g., surgical correction of tumors, antibiotics for infections, antiarthritic drugs for osteoarthritis). 

A variety of drugs with antiepileptic, antispastic, or antidepressant activity are used to manage cranial neuralgias. These compounds are usually more useful than agents with general analgesic properties. 

Cluster headache and other trigeminal autonomic cephalalgias Other primary headaches Headache attributed to head and/or neck trauma Headache attributed to cranial or cervical vascular disorder Headache attributed to non-vascular intracranial disorder Headache attributed to a substance or its withdrawal Headache attributed to infection Headache attributed to disorder of homeostasis Headache or facial pain attributed to disorder of cranium, neck, eyes, ears, nose, sinuses, teeth, mouth, or other facial or cranial structures Headache attributed to psychiatric disorder Cranial neuralgias and central causes of facial pain Other headache, cranial neuralgia, central or primary facial pain... 

Trigeminal neuralgia A disorder of the fifth cranial (trigeminal) nerve characterized by excruciating paroxysms of pain in the face. 

Exposure of humans to dichloroacetylene in a variety of settings has caused headache, dizziness, nausea, vomiting, eye irritation, mucous membrane irritation, and neurological disorders, manifested as paresis and neuralgia in several cranial and cervical nerves. " In some cases the cranial nerve involvement persisted for several days to years. Extreme nausea occurred among individuals exposed to levels as low as 0.5-1.0ppm. In an early report two deaths occurred several days after dichloroacetylene exposure autopsy revealed cerebral edema. 

Some types of head or facial pain are mediated through three cranial nerves bearing sensory fibers—V, VI, and VII. Most notable among these are trigeminal neuralgia and Bell s palsy. 

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