Trigeminal Neuralgia

Subject: Medical and Surgical Nursing I (Theory)

Overview

The trigeminal nerve is responsible for transmitting facial feeling to the brain, and it can be severely affected by a disorder known as trigeminal neuralgia, which causes persistent pain. Trigeminal neuralgia sufferers are vulnerable to sudden, severe discomfort from even modest facial stimulation, such as that caused by cleaning their teeth or applying cosmetics. A number of people have episodes of extreme discomfort that seem like an electric shock when touching their face, chewing, speaking, or cleaning their teeth, among other activities. The trigeminal nerve is located at the base of the brain, and the problem typically arises when a normal blood vessel, such as an artery or vein, comes into touch with the nerve. The nerve is compressed and malfunctions as a result of this contact. Medicines used to treat this condition include those that reduce muscle spasms and prevent convulsions. Microvascular decompression and Gamma knife radiosurgery are two surgical methods for treating trigeminal neuralgia.

Injuries to the trigeminal nerve, which transmits facial feeling to the brain, can lead to a painful disease known as trigeminal neuralgia. Trigeminal neuralgia sufferers may have a sudden, intense pain attack at the slightest facial stimulation, such as when cleaning their teeth or applying cosmetics. Trigeminal neuralgia can escalate from brief, moderate attacks to longer, more regular episodes of burning agony. Women are more likely than males to get trigeminal neuralgia, and persons over the age of 50 are at an increased risk. 
Symptoms

  • Sharp, stabbing pain that comes in waves and sometimes seems like an electric shock
  • Constant discomfort that comes on suddenly or is prompted by simple actions like stroking the face, eating, speaking, or cleaning teeth
  • Pain that comes in waves from a few seconds to a few minutes
  • Multiple episodes over the course of several days, weeks, or months; intermittent intervals of relief in between.
  • Chin, chin muscles, teeth, gums, lips, and occasionally the eye and forehead might experience pain since these are all parts of the body that the trigeminal nerve supplies.
  • Face pain that only affects one side at a time
  • Localized pain or widespread discomfort
  • The frequency and severity of attacks are increasing.

Causes

The dysfunction of the trigeminal nerve causes trigeminal neuralgia, commonly known as tic douloureux. The trigeminal nerve, located near the base of your brain, is commonly affected when an artery or vein presses against it. The nerve is compressed and malfunctions as a result of this contact.

Trigeminal neuralgia pain can be prompted by a number of different stimuli, including but not limited to:

  • Shaving
  • stroking your face
  • Eating
  • Drinking
  • Carefully cleaning your teeth
  • Talking
  • Inconvenience while applying cosmetics
  • smiling
  • Encountering a breeze

Treatment and Drugs

Medication is the standard first line of defense for trigeminal neuralgia, and many patients improve sufficiently to stop therapy altogether.

Medications:

  • Anticonvulsants. Carbamazepine (Tegretol) is the medication most commonly prescribed by doctors to treat trigeminal neuralgia, and it has been proved to be effective.
  • Agents that prevent muscle spasms. Carbamazepine can be used alone or in conjunction with muscle relaxants like baclofen (Gablofen, Lioresal).
     

Surgery

Trigeminal neuralgia surgery possibilities include:

  • Microvascular decompression.
  • Gamma knife radiosurgery.

Nursing management

If unexpected cold is known to irritate the nerve in question, advise the patient to avoid doing anything that could cause the afflicted cheek to be exposed to it. Avoid, for instance,

  • Cool drinks
  • Cold air
  • Swimming in cold water
  • Prescribe medicine such as Tegretol, a prescribed pain reliever and preventative, will be given as directed.
  • Long-term drug usage is associated with increased serum drug levels.
  • Maximum pain alleviation with little damage is achieved through surgical severance of the afflicted nerve.
  • Stick to room temperature, soft foods that don't need a lot of chewing.
  • Get out of the way of any breezes or drafts.
  • The patient must be taught how to avoid experiencing discomfort as a result of their surroundings.

References

neuropathy.gear.host/trigeminal-neuropathy-treatment.php
advancedspinedoctor.com/trigeminal-neuralgia-largo/\sbodhin.in/trigeminal-neuralgia.php
curetogether.com/findall.php?sct=jaw+pain
studylib.net/doc/6730810/therapeutics-–-neuralgias\sdocplayer.net/15512735-Acupuncture-management-of-neurological-pain.html
To View Documents Online: documentslide.com
pharmacypedia.org/diseases-and-conditions/tic-douloureux-trigeminal-neuralgia/
https://my-ms.org/symptoms pain.htm
Author: Mandal, G. (August 2013).
Towards a Conceptual Framework for Adult Health Nursing Education (2nd ed.). Location: Makalu Publishing House, Dilllibazar, Kathmandu. Information retrieved from www.livewellpainclinic.com/Admin/File/trigeminal.html in August 2013.
Things to remember
  • The trigeminal nerve is responsible for transmitting facial feeling to the brain, and it can be severely affected by a disorder known as trigeminal neuralgia, which causes persistent pain.
  • Chin, chin muscles, teeth, gums, lips, and occasionally the eye and forehead might experience pain since these are all parts of the body that the trigeminal nerve supplies.
  • The dysfunction of the trigeminal nerve causes trigeminal neuralgia, commonly known as tic douloureux.
  • Medication is the standard first line of defense for trigeminal neuralgia, and many patients improve sufficiently to stop therapy altogether.
  • If unexpected cold is known to irritate the nerve in question, advise the patient to avoid doing anything that could cause the afflicted cheek to be exposed to it. Don't, for instance, Chilly drinks, Brisk breeze
  • Stick to room temperature, soft foods that don't need a lot of chewing.
Questions and Answers

The trigeminal nerve, which transmits sensation from your face to your brain, is afflicted by trigeminal neuralgia, a chronic pain condition. If you suffer from trigeminal neuralgia, even minor facial stimulation, such as when you brush your teeth or put on makeup, can cause excruciating pain.

Symptoms

  • Acute, shooting, or jabbing pain episodes that might seem electric shock-like.
  • Pain that comes on suddenly or that is brought on by actions like stroking the face, eating, speaking, or cleaning teeth.
  • Painful bursts that linger for a few to several seconds.
  • Periods with little discomfort for some people; episodes of many assaults spanning days, weeks, months, or longer.
  • Trigeminal nerve-supplied areas such as the cheek, jaw, teeth, gums, lips, and, less frequently, the eye and forehead.
  • Facial pain that only affects one side at a time.
  • A concentrated area of pain or widespread discomfort.
  • Increasing frequency and ferocity of attacks over time.

Causes

The trigeminal nerve's normal function is interfered with in trigeminal neuralgia, also known as tic douloureux. The trigeminal nerve, located at the base of your brain, is frequently in touch with a regular blood vessel, in this example an artery or a vein, which causes problems. The nerve becomes damaged as a result of the pressure this contact puts on it.

Trigeminal neuralgia can be brought on by a number of factors, including:

  • Shaving,
  • Stroking your face,
  • Eating,
  • Drinking,
  • Brushing your teeth,
  • Talking,
  • Putting on makeup,
  • Encountering a breeze,
  • Smiling.

 

Nursing management

  • Instruct patient to avoid exposing affected cheek to sudden cold if this is know to trigger the nerve . for example, avoid:
  • Iced drink
  • Cold wind
  • Swimming in cold water
  • Administration of drug as order,
  • Tegretol - relieve and prevent pain
  • Serum blood level of drug are mentioned in long term use.
  • Surgical procedure to sever the affected nerve provide optimum pain relief with mknimum impairment.
  • Eat food that is easily chewed and are served at room temperature.
  • Avoid drafts and breezes.
  • Instruct patient in method to prevent environmental stimulation of pain.

 

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