This is a PPT of Trigeminal neuralgia for Masters students . take an idea from it...................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
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
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
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.
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
; neither electrophysiologic tests nor magnetic resonance imaging shows any significant abnormalities
A percutaneous rhizotomy is a minimally invasive procedure to treat trigeminal neuralgia. Our surgeons use a small needle to make a controlled, minor injury to one of your facial nerves (your trigeminal nerve). This controlled injury disrupts the pain signals that your trigeminal nerve sends out.
Stereotactic radiosurgery technology uses many small gamma rays to deliver a precise dose of radiation to the target. Stereotactic radiosurgery (SRS) uses many precisely focused radiation beams to treat tumors.