• Neuralgia posherpética,
• Neuralgia of the trigémino.

There are neuralgias without well-known cause but others owe to:

• Chemical annoyance of the nerve.
• The traumatic inflammation for blows or after surgery.
• Compression for other structures as tumors and inflamed textiles (infections).

The most frequent neuralgia is the neuralgia of the trigémino, it affects to the principal sensitive nerve of the face, the nerve trigémino, for it there take place pains that are radiated by the face in the sensitive trajectory of the nerve.
Pains take place in sudden and short attacks in a side of the face, along one of the areas inervadas for the trigémino. The pain usually very intense and cause be facial grimaces, "painful tic".

In general the neuralgia of the trigémino is of unknown cause but sometimes it is secondary to children aneurismas or tumors that press the nerve, other times like a symptom of the multiple sclerosis, to arthritis or diabetes.
The pain can be cocked by certain stimuli as they can be chewing, speaking, swallowing or touching an area of the face limited.

Other neuralgias appear after infections of the virus of the herpes Zoster. In this case it is called a neuralgia postherpética, and usually produces an intense pain after the cutaneous sharp phase of the illness finds eliminated. In this case the pain deteriorates with the movements or the contact of the affected area.

There are other neuralgias after infectious illnesses like the secondary ones to the syphilis and the illness of Lyme.
The diabetes can cause neuralgias for the alteration of the arteries that irrigate the nerves. To the beginning it can produce pain then to injure the nerve and to produce the opposite (anesthesia or loss of sensibility).
It is possible to think secondary neuralgias to the diabetes in the nerve trigémino in the syndrome of the carpal tunnel - that it produces pain and contractions in the hand and in the neuralgia of the thigh, due to the affectation of the cutaneous nerve side femoral.
The control of the diabetes and the level of sugar in the blood usually improves the symptoms of the secondary neuralgias.

Other illnesses that can produce neuralgias are:

• The chronic renal insufficiency.
• The porfiria.
• Treatments with certain medicines.

The proper result of an interview in which the symptoms are described, associated with the anatomical knowledge of the doctor they serve to face the nerve affected by the neuralgia.

The neuralgia of the trigémino presents itself as a pain in the second and third branch of the nerve (low part of the face and jaw) and rarely fond of the first branch of the nerve (front). Also they can be the loss of the reflexes tendinosos deep, and the loss of the muscular mass of the area. Sometimes there is a local absence of the sudoración and an increase of the sensibility in the skin.
There are able to be detected usually the points of gatillamiento in which a light contact unleashes the pain.

It is possible to confirm the diagnosis by means of an electromiografía, which is a study that examines the electrical activity of the nerves.
In this study there measures itself the nervous conduction of sensitive stimuli, of motive stimuli of the muscles. Depending on the results it is possible to diagnose the injury, the grade of the injury and the level of the nerve where the problem is.

Other studies that realize sound to discard the presence of a diabetes, arthritis, syphilis, shortcomings vitamínicas, etc... Inclusive before the suspicion of the existence of a multiple sclerosis it is possible to go so far as to realize a Nuclear Magnetic Resonance of the brain and a study of the spinal liquid obtained by means of a lumbar puncture.

First of all it is always the treatment of the cause of the neuralgia if it has been found. If there is a compression of the nerve for tumors they must be extirpated.
The use of traditional analgesics (AAS, Paracetamol, Ibuprofeno) is not usually of many efficacy, sometimes it is possible that his association with codeine improves the symptoms of the neuralgia.
For it they usually use medicines anticonvulsivantes like the carbamazepina, gabapentin or the fenitoína, especially in the neuralgia idiopática of the trigémino.
Sometimes it collaborates to other medicines of antidepressing activity like the amitriptilina. Also the local application is used in ointments with capsaicina.

When all these means fail the blockade of the nerves appears with the use of local injections of anesthetic agents. And of more direct form by means of a surgery to diminish the sensibility of the nerve.
The surgery of the neuralgia comprises the destruction of the nerve by means of skills of local radio frequency, (termocoagulación) heat, compression for ball and chemists' injection (like glicerolisis). The surgery is not radical, sometimes there are side effects of the destruction of the function of the nerve and the pains persist.
There are other more punctual methods in every neuralgia with diverse results.