Talk:Neuralgia

Neuralgia
This article needs disambiguation from Neuropathic pain, else merger. --Una Smith (talk) 01:03, 30 March 2008 (UTC)

Antidepressants
This article lists Lyrica as an antidepressant, when it is an anticonvulsant. I have corrected the information. Brattysoul (talk) 20:14, 12 January 2009 (UTC)

Just reviewed the page and not only was Lyrica returned to the previous edit as an antidepressant, but Neurontin was included as an antidepressant. These two medications have been and are listed with the FDA as anti convulsants. Because their medical value is similar to the way anti depressants work with neuropathic pain, certainly does not automatically change the classification of Lyrica and Neurontin. According to the FDA, Lyrica is an antiepileptic medication, as is Neurontin (AEDs). Nowhere is there the claim they are anti-depressants.

Lyrica(Pregabalin) and Neurontin(Gabapentin) arein the AED therapy as a GABA Analog product classification.

I've revised the article to reflect the correct info regarding the medications used for treatment of this condition. If it's changed again, it should be considered vandalism, and it should be considered that there is the possibility that someone is posting their own POV rather than maintaining a neutral view here. Brattysoul (talk) 02:43, 29 April 2009 (UTC)

Plain English
Might this be put into more plain English? I am not a doctor and saying that Neuralgia can be simply put as .... where .... is something that I suspect few lay people would understand is not particularly helpful. I would edit it myself but I am no doctor. —Preceding unsigned comment added by 82.71.57.154 (talk) 21:08, 16 April 2009 (UTC)
 * I've tried to add a clarification of the basic concept. The article still could use a lot of copy-editing. Looie496 (talk) 16:18, 17 April 2009 (UTC)

Surgery
I have removed the POV remark regarding surgery, since there is not a definitve reference other than a "personal" interview with Michael Stechison. The surgery in question is in reference to Peripheral Nerve Entrapment(carpal tunnel and ulnar nerve) repair. When accessable information can be included to back up the statement about surgery success, then it should be replaced.

Surgery is still in its infancy and not being used as yet in the same way medications are in treatment of neuralgia etc.

By the way, I went to several neurologists regarding this very surgery I read about in a diabetic magazine-I live in a city with highly regarded medical teaching schools, including but not limited to the Univ of Penn and Jefferson Univ--and this surgery was discouraged due to its ineffectiveness and there showed only about 20% improvement after surgery in many patients. Brattysoul (talk) 03:14, 29 April 2009 (UTC)

Neuralgia is not causalgia
Neuralgia is not causalgia: "Neuralgia was first recognized by Silas Weir Mitchell, a neurologist in the American Civil War" is unfortunately wrong. The first mention of "neuralgia" was by Ambroise Paré to describe a neuralgia of Charles IX, the King of France. In 1802, François Chaussier, by his masterful description, gave nosological birth to neuralgia: 1) By the nature of the pain, which is at the same time acute, agonizing, sometimes and particulary at the beginning, with torpor or formication, more often with pulsations, throbbing and successive nagging, without flushing, without heat, without pressure and apparent swelling of the member, which returns in fits and starts more or less long and close together, frequently irregular, sometimes recurring; (...) 2) By the site of the pain, which is always fixed on a trunk, on a branch of the nerve, and which, at its height, propagates and shoots off from the primary point affected to all its ramifications, runs through them all like a flsh of lightning, right to the furthest extremities, follows them into their various connections, affects them, sometimes successively one after the other, somtimes all together, or which at other times limits itself more particulary to one or two its filaments. Rey, R. (1993). Histoire de la douleur. Paris: La Découverte. --Spicherc (talk) 16:54, 28 November 2009 (UTC)

Signs and Symptoms
The entry under this heading is neither a sign nor a symptom. A sign is something someone (like a doctor) can see, whereas a symptom is something the patient can describe. What's listed here is a couple of secondary effects, which describe nothing. 4 August 2012 — Preceding unsigned comment added by 76.175.162.195 (talk) 14:55, 4 August 2012 (UTC)
 * Thanks for pointing this out. I've removed the section because you can't have a signs and symptoms for an article about a symptom, and it doesn't belong in any of the section titles listed for articles like this in the Medical Manual of Style. The text is also fairly self-evident. Graham 87 04:06, 5 August 2012 (UTC)

Listing neuralgias
Feel free to add. (UTC)
 * Neuralgias of the head and face IASP
 * 1) Trigeminal neuralgia (Tic douloureux)
 * 2) Secondary neuralgia (trigeminal) from central nervous system lesions (Arnold-Chiari syndrome)
 * 3) Secondary trigeminal neuralgia from facial trauma
 * 4) Acute herpes zoster neuralgia (trigeminal)
 * 5) Postherpetic neuralgia (trigeminal)
 * 6) Geniculate neuralgia (VIIth cranial nerve): Ramsay Hunt Syndrome
 * 7) Neuralgia of the nervus intermedius
 * 8) Glossopharyngeal neuralgia (IXth cranial nerve)
 * 9) Neuralgia of the superior laryngeal nerve (Vagus nerve neuralgia)
 * 10) Occipital neuralgia
 * 11) Hypoglossal neuralgia
 * 12) Glossopharyngeal pain from trauma
 * 13) Hypoglossal pain from trauma
 * 14) Tolosa-Hunt syndrome (painful ophthalmoplegia)
 * 15) SUNCT syndrome (shortlasting, unilateral, neuralgiform pain with conjunctival injection and tearing)
 * 16) Raeder’s syndrome (Raeder’s paratrigeminal syndrome)
 * Other
 * 1) Intercostal neuralgia
 * 2) Vagus nerve neuralgia — Preceding unsigned comment added by Anthonyhcole (talk • contribs) 10:41, 7 January 2014

Rewrite
Hi all, I propose we rewrite this page to effectively make it a limited explanation of the neuralgia terminology. At the moment the page is not clearly distinct from neuropathic pain, this is not entirely surprising Neuralgia is by most good defintions a form of neuropathic pain. To me it means neuropathic pain in the division of one nerve and is really just a term we tack on to a number of anatomical locations to given neuropathic pain diseases a fancy name. As such I'm not sure this article is really adding a lot of information. There's also a lot of incorrect information, it will take some time to correct this. But for example, I'm not sure a glial scar has anything to do with a neuralgia, that would typically cause neuropathic pain in multiple dermatomes, I'm not sure that macrophages have a major role in the Brain or spinal cord. Or for example, are punch biopsies used to diagnose neuralgia, I don't think so, changes on biopsy would indicate painless neuropathy not neuralgia, and then I don't understand how that would help the patient, generally punch biopsies are used in research or to diagnose a cause of loss of sensation. PainProf (talk) 16:36, 29 May 2020 (UTC)
 * The function of an encyclopedia is to present all the information we have that has been published in reliable sources. To that end, I don't believe it is an improvement to limit the scope of the article. You should not be removing content sourced to reliable sources based on your own whim. If there is content that you think is not supported by sources, the courteous way of raising that is with a citation needed tag in the first instance.
 * I doesn't matter whether you're sure about glial scars or macrophages; all that matters is what the best quality sources say about their relationship to neuralgia. So if you have good quality sources that contradict what is written in the article, or would add information not current present, then please discuss them here. On Wikipedia, we start from the sources and then write the text. Hope that helps. --RexxS (talk) 18:01, 29 May 2020 (UTC)
 * I doesn't matter whether you're sure about glial scars or macrophages; all that matters is what the best quality sources say about their relationship to neuralgia. So if you have good quality sources that contradict what is written in the article, or would add information not current present, then please discuss them here. On Wikipedia, we start from the sources and then write the text. Hope that helps. --RexxS (talk) 18:01, 29 May 2020 (UTC)

Hi thanks, my rationale is that in certain cases, these are somewhat irrelevant but I think this article is making an unhelpful distinction essentially.The article correctly describes that neuralgias are clinical entities where there is neuropathic pain in one nerve territory / innervation area but then appears to go into a very general explanation of the mechanisms of neuropathic pain and its treatment and diagnosis. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6310153/ Only a limited number of neuropathic pain conditions are described as neuralgias under ICD10. In ICD-11 all of these fall under the clinical entity of neuropathic pain. I'm actually not sure where the explanations of neuropathic pain listed here came from~, they are not mainstream explanations. I think this annual review although a little old is perhaps the easiest synthesis on the topic https://pubmed.ncbi.nlm.nih.gov/19400724/. I think narrowing the scope to explain the umbrella term and maybe the history of the term would be helpful with links to the daughter clinical entities and the parent clinical entity, in the view that they are treated in the same manner and are mechanistically similar. PainProf (talk) 18:25, 29 May 2020 (UTC)
 * Have a look at WP:MEDRS. The best sources are usually considered to be from the last five years, but much depends on context. The problem with trying to narrow the scope is that without authoritative sources that define the scope, you exclude content that can be found in reliable sources. I do agree that having some history of how the term has been used would be a worthwhile addition, so what sources would you use for that? --RexxS (talk) 19:11, 29 May 2020 (UTC)
 * yes the best PubMed indexed review articles/ meta analysis are from the last five years--Ozzie10aaaa (talk) 12:54, 1 June 2020 (UTC)
 * yes the best PubMed indexed review articles/ meta analysis are from the last five years--Ozzie10aaaa (talk) 12:54, 1 June 2020 (UTC)

I think the IASP definitions are helpful for understanding the overall history, the term neuralgia was introduced before neuropathic pain by the IASP (https://www.iasp-pain.org/PublicationsNews/Content.aspx?ItemNumber=1673&navItemNumber=677). However, neuropathic pain has really become the all encompassing term in modern medicine. I checked in modern textbooks (the Textbook of Pain, 2016, eds. SB McMahon et al. and Practical pain management 2014 5th Edition eds. Benzon et al. - I think that an earlier version of this textbook was the most common citation before. There are no uses of this term other than when describing forms of neuropathic pain, that retain this interesting bit of medical history. I would also note that each source on this page describes neuropathic pain then describes each individual neuralgia as a form of neuropathic pain rather than describing neuralgias. Basically, it's for all intents and purposes an antiquitated term no longer commonly used in medical practice except as a part of other diseases names. As a result when we talk about treatment, and diagnosis, this will always be essentially a repetition which is why it might be better to just explain the term and its history linking to sub-articles on defined neuropathic pain diseases known as neuralgias. PainProf (talk) 23:58, 29 May 2020 (UTC)


 * My first thought was, "Wait, this is still a thing?" I somehow associate this with characters in novels, not modern diagnoses (except for specific conditions, such as trigeminal neuralgia).
 * In the broader sense, Wikipedia's ruleset struggles when there are slow changes to the accepted answers in the real world. Sudden, clear changes are easy, but a gradual shift from one name or definition to another is hard.  If ICD-11 is dropping the term, then we will eventually drop it, too.  In between now and then, we'll be various degrees of "wrong", depending upon how up-to-date the speaker's view is.
 * Anthonyhcole, are you around? What do you think about User:PainProf's idea of focusing this article? WhatamIdoing (talk) 17:19, 12 June 2020 (UTC)
 * In the end I felt it was fine to just change the existing hat note which linked to an obscure condition to link to neuropathic pain, I get your point as icd-10 codes are a bit ambiguous. Certainly in (fiction and earlier medical) literature which is actually covered well, its very hard to tell what they were writing about because for example neuralgia to some really meant a headache. Thanks for the advice. I do hope to eventually get round to fixing the treatment section which is weirdly vague, and largely inaccurate/out of date. If anyone has a good idea of how to approach that section on this page without rehashing that would be good PainProf (talk) 01:51, 19 June 2020 (UTC)

Section "Mechanisms" poorly linked to topic
What's the connection between this material and neuralgia? It's not made clear. Wegesrand (talk) 14:54, 29 November 2023 (UTC)