2. Trigeminal neuralgia
• Trigeminal neuralgia is a condition
characterized by pain coming from the
trigeminal nerve, which starts near the top of
the ear and splits in three, toward the eye,
cheek and jaw. We have two trigeminal nerves
for each side of our face, but trigeminal
neuralgia pain most commonly affects only
one side.
3. • The pain can be triggered by an action as
routine and minor as brushing your teeth,
eating or the wind. Attacks may begin mild
and short, but if left untreated, trigeminal
neuralgia can progressively worsen.
4.
5.
6. The Trigeminal Nerve
• The trigeminal nerve is one set of the cranial
nerves in the head. It is the nerve responsible for
providing sensation to the face. One trigeminal
nerve runs to the right side of the head, while the
other runs to the left. Each of these nerves
has three distinct branchest"Trigeminal" derives
from the Latin word "tria," which means three,
and "geminus," which means twin. After the
trigeminal nerve leaves the brain and travels
inside the skull, it divides into three smaller
branches, controlling sensations throughout the
face:
7. Conti….
• Ophthalmic Nerve (V1): The first branch controls
sensation in a person's eye, upper eyelid and
forehead.
• Maxillary Nerve (V2): The second branch controls
sensation in the lower eyelid, cheek, nostril,
upper lip and upper gum.
• Mandibular Nerve (V3): The third branch controls
sensations in the jaw, lower lip, lower gum and
some of the muscles used for chewing
8. Types of trigeminal neuralgia?
• Typical (Type 1) trigeminal neuralgia.
Painful episodes that are sharp, intense and sporadic. You
may feel pain and/or a burning sensation all over your
face that can last anywhere from a few seconds to two
minutes. Though there will be pain-free breaks in
between episodes, this can continue for up to two hours.
• Atypical (Type 2) trigeminal neuralgia.
Less painful and intense but more widespread. You’ll
likely feel constant pain, notably stabbing and/or burning
sensations, along with persistent aches and pains. With
atypical trigeminal neuralgia, you may have more
difficulty controlling the symptoms.
10. What are the 5 steps in the neurological assessment?
MENTAL STATUS TESTING
It should be assessed first in all patients. Mental
status testing can be divided into five parts:
1. Level of alertness
2. Focal cortical functioning
3. cognition
4. mood and affect
5. and thought content
11. Components of a neurological examination?
There are many components to a neurological
exam, including
• Cognitive testing,
• Motor strength and control
• Sensory function
• Gait (walking), cranial nerve testing
• and balance
12. Causes of Trigeminal Neuralgia
Trigeminal neuralgia usually occurs spontaneously,
but is sometimes associated with facial trauma or
dental procedures. The condition may be caused by
a blood vessel pressing against the trigeminal
nerve, also known as vascular compression.
• Temporomandibular joint disorders (TMD)
• Sinus infection.
• Trigeminal neuralgia.
• Hemifacial spasm etc
13. Attacks of TN may be triggered by the
following:
• Touching the skin lightly
• Washing
• Shaving
• Brushing teeth
• Blowing the nose
• Drinking hot or cold beverages
• Encountering a light breeze
• Applying makeup
• Smiling
• Talking
14. Diagnossis
Based on a few different factors:
• The specific type of pain you’re feeling.
• The exact spot on your face where you feel
pain.
• Which activities or actions trigger a painful
episode.
• MRI
15. Prevention and treatment
• by avoiding certain activities that cause severe, intense
pain.
• symptoms can be treated with a combination of
medications, surgery and complementary therapies;
• Anticonvulsant drugs
• Antidepressant
• Muscle relaxants
• Other medications. A botulinum toxin inject may be
used to block sensory nerves. In some instances, nerve
blocks are used to provide temporary relief
17. Complementary therapies
• Yoga.
• Creative visualization.
• Meditation.
• Aromatherapy.
• Low-impact exercise.
• Additional therapies that may be helpful include:
• Acupuncture.
• Chiropractic.
• Supportive counseling or therapy.
• Biofeedback.
• Vitamin therapy.
• Nutritional therapy.
18. Nursing Management
• Asses the general condition of patient
• Instruct the client to avoid factors that can trigger the attack
and result in exhaustion and fatigue.
• Avoid foods that are too cold or too hot.
• Chew foods in the affected side.
• Use cotton pads gently, wash face and for oral hygiene.
• Provide teaching to clients who have sensory loss as a result
of a treatment. Provide information about
condition/prognosis, treatment needs, and limitations
• Inspection of the eye for foreign bodies, which the client will
not be able to feel, should be done several times a day.
19. Cont…
• Warm normal saline irrigation of the affected eye two to three
times a day is helpful in preventing corneal infection.
• Dental check ups every 6 months is encouraged, since dental
caries will not produce pain.
• Explain to the client and his family the disease and its
treatments.
• Avoid exposing affected cheek to sudden cold ( ice drink, cold
winds, swimming in cold water.
• Avoids drafts & brezzes.
• Develop a multidisciplinary plan for client and family teaching.
• Provide emotional support
• Assess neurological status frequently
