Ramaprasad S Associate Professor Neurosciences nursing

1. Trigeminal Neuralgia

2. Definition
It is a disorder of the cranial nerve also called as cranial
neuropathy. It is a condition characterized by the pain in the territory of
a trigeminal nerve

4. Etiological Factors
Idiopathic
Compression of the trigeminal nerves
Compression by blood vessels
Infections /MS
Tumors
Injury
Surgical conditions
accidents

5. Pathophysiology
Causes like atherosclerotic blood vessels compress the root of the
trigeminal nerve
Focal demyelination
Nerve excites uncontrollably
Cause intense pain

7. Clinical Features
1. Severe shooting pain
2. Pain on touching the face chewing or while brushing
3. Pain may be few seconds to minutes
4. Facial spasm
5. Decreased corneal reflex
6. Paralysis of cranial nerve V

9. Management
Medical Management
a. membrane stabilizing drugs (carbamazepine (100mg/day
followed by 400mg-800mg 8 hourly )/phenytoin (300
mg/day)/gabapentin) upto 4 weeks
b. Analgesics
c. Sedatives
d. Antidepressants
e. Clonazepam 05-2 mg 8 hourly

10. Surgical treatment
1. Injection of alcohol into trigeminal nerve
2. Radiofrequency coagulation of ganglion
3. Sectioning of trigeminal ganglion
4. Thermocoagulation
5. Microvascular decompression

11. Alcohol
injection

12. Microvascular Decompression

14. Nursing Management
Careful assessment of pain
Check nature, location, intensity and severity of pain
Provide pain medications
Health education and awareness
Hygienic measure
Avoid triggering factors
Advice the patient to cover their face while blowing breeze and
cold
Caution while shaving