This is a PPT of Trigeminal neuralgia for Masters students . take an idea from it...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

2. TRIGEMINAL
NEURALGIA
ANAMIKA
MSN ORTHOPAEDICS

3. INTRODUCTION
 Trigeminal neuralgia/TN / tic douloureux.
Neuropathic pain disorder of the fifth cranial (trigeminal) nerve
The International Classification of Headache Disorders, identifies three
subtypes based on underlying cause:
CLASSIC: No apparent cause except neurovascular compression
SECONDARY: caused by an underlying disease, such as multiple
sclerosis, AVM, or SOL
IDIOPATHIC: unknown cause

4. Risk factors
Herpes zoster
History of multiple sclerosis
>50 yrs
Disorder of blood vessels
 female

5. causes
Exact cause may be unknown
Compression of the trigeminal nerve root
Underlying disease, such as multiple sclerosis, arteriovenous
malformation, or a space-occupying lesion

6. Pathophysiology
DISTRIBUTION(branches )
1) ophthalmic
2) maxillary
3) mandibula
This nerve affects chewing movements and sensations of the face, scalp, and
teeth.
Compression of the nerve root occurs from an unknown cause.Demyelination
occurs in the area of compression.
An impulse triggers the area, and interaction or short-circuiting of touch and pain
fibers occurs. Paroxysmal attacks of excruciating facial pain result.

7. Clinical features
Unilateral burning facial pain (R>L)that ranges from electric shock-like jabs to
constant aching pain, lasts for 1 or 2 minutes
Localized in an area innervated by the trigeminal nerve
Initiated by a light touch to a hypersensitive area
Attacks possibly occurring after certain triggers, such as:
Washing the face, touching the face, applying makeup or lotion, a draft of air, exposure
to heat or cold, brushing the teeth, eating, smiling, or talking, drinking hot or cold
beverages, shaving .
Patient denial of touching the affected area

8. Diagnosis
Neurologic examination
Magnetic resonance imaging
Blink reflex study may detect lesions.

9. Management
MEDICAL MANAGEMENT
Carbamazepine - first-line agent
Phenytoin, gabapentin, lamotrigine,
pregabalin, baclofen, used alone or as add-on
therapy

10. PROCEDURES
1) Nerve block
2) Gamma knife radiosurgery
3) Percutaneous radiofrequency rhizotomy
SURGERY
1) Microvascular decompression of cranial nerve V
2) Stereotactic radiosurgery
3) Percutaneous balloon micro compression

11. Nursing management
i. Assess the patient's pain
ii. Obtain specimens for laboratory testing drug levels.
iii. Provide safety precautions related to the sedative effects
of prescribed medications.
iv. Provide nutritional management.
v. Frequently monitor weight.
vi. Allow the patient to verbalize feelings.
vii.Provide postoperative care, including surgical site care
and monitoring.

12. SUMMARY

13. CONCLUSION
Trigeminal neuralgia is a chronic pain condition that affects
the trigeminal nerve, which carries sensation from your
face to your brain. It is characterized by sudden, severe
facial pain lasting from a few seconds to several minutes.

14. Bibliography
1.Hinkle J. L by Cheever K.K. Brunner & Suddarth’s Textbook of
Medical Surgical Nursing South Asia Edition, volume 2 ,New Delhi,
Wolters Kluwer, 2018,
2.Lewis S L, Bucher 2. Heitkemper M.M, Chintamani Medical
surgical Nursing, sed south Asia edition, volume- New Delhi,
Elsevier Publication, 2018.
3.https://advisor.lww.com/lna/document.do?bid=4&did=1232123&hits
=neuralgia,trigeminal

15. THANK YOU