TRIGEMINAL NEURALGIA & BELL'S PALSY Flashcards
aka as Tic Douloureux
Trigeminal Neuralgia
What cranial nerve is the Trigeminal Neuralgia
Fifth Cranial Nerve
What is trigeminal neuralgia?
Paroxysms of pain in the area innervated by the 2nd and 3rd branches of the trigeminal nerve
What is Trigeminal Neuralgia?
-aka as Tic Douloureux
-fifth cranial nerve
- Paroxysms of pain in the area innervated by the 2nd and 3rd branches of the trigeminal nerve
Causes of Trigeminal Neuralgia
-Stimulation of the trigger points
** -Washing face
-Shaving
-Brushing the teeth
-Eating
-Drinking**
-draft of cold air
- direct pressure
Diagnostic of Trigeminal Neuralgia
MRI
Clinical Manifestations of Trigeminal Neuralgia
-Unilateral pain
-Sudden closing of the eye
- Twitching of the mouth
Drug Management for Trigeminal Neuralgia
-Antiseizure agents
-Carbamazepine (Tregretol)
-Gabapentin (Neurontin)
What is the mechanism of action of antiseizure?
Reduces transmission of impulses at certain nerve terminals
Purpose of the drug Gabapentin (Neurontin)
for pain control
Surgical Management of Trigeminal Neuralgia
-Microvascular Decompression
- Percutaneous Balloon Microcompression
Relieve the contact between the cerebral vessel and the trigeminal nerve root entry
Microvascular Decompression
Disrupts large myelinated fibers in all three branches of the trigeminal nerve
Percutaneous Balloon Microcompression
What is Microvascular Decompression?
Relieve the contact between the cerebral vessel and the trigeminal nerve root entry
What is Percutaneous Balloon Microcompression?
Disrupts large myelinated fibers in all three branches of the trigeminal nerve
Nursing Management of Trigeminal Neuralgia
-Prevent pain by identifying causes of pain
-Perform personal hygiene during pain-free intervals
-instruct patient to chew on the unaffected side post-operatively; aspiration precaution
-give artificial tears
aka facial paralysis
Bell’s Palsy
Bell’s palsy is also known as?
also known as facial paralysis
Unilateral inflammation of the seventh cranial nerve
Bell’s Palsy
What is seventh cranial nerve?
Facial Nerve
Weakness or paralysis of the facial muscles on the affected side
Bell’s Palsy
What is Bell’s Palsy?
-aka facial paralysis
-Unilateral inflammation of the seventh cranial nerve
- weakness or paralysis of the facial muscles on the affected side
Etiology of Bell’s Palsy
-Idiopathic
-Vascular ischemia
-Viral disease (herpes simplex, herpes zooster)
-Autoimmune disease
What specific viral disease that causes bell’s palsy to occur?
-Herpes simplex
-Herpes zooster
Pathophysiology of the Bell’s Palsy
-Because of the compression on the facial nerve; cause inflammation
-Ischemic necrosis of the nerve
Clinical Manifestations of Bell’s Palsy
-Facial distortion
-Increased lacrimation
-Pain in the face, behind the ear, & in the eye
- speech difficulties
-unable to eat
Pain can be felt in the
Pain in the face, behind the ear, & in the eye
Medical Management of Bell’s Palsy
-Corticosteroids
- Electrical stimulation
Reduces inflammation & edema
Corticosteroids
This is given early to alleviate symptoms fast
Corticosteroids
Purpose of Corticosteroids
-Reduces inflammation and edema
-Given early to alleviate symptoms fast
Purpose of electrical stimulation
Prevents muscle atrophy
Nursing Management of Bell’s Palsy
-Eye should be covered with a protective shield at night
-Apply moisturizing eye drops or eye ointment at bedtime
-Wrap around sunglasses or goggles during daytime
-Suggest massaging the face several times daily
- Encourage facial exercises
Why we need to apply moisturizing eye drops or eye ointment at bedtime?
To prevent injury
Why we need to wrap-around sunglasses or goggles during daytime
To decrease normal evaporation from the eye
Rationale for massaging the face several times daily
to maintain muscle tone
What are the examples of facial exercises?
-wrinkling of the forehead
-blowing out the cheeks
-whistling
Why we need to encourage facial exercises?
To prevent muscle atrophy
How would you describe the unilateral pain
Pain becomes more frequent and agonizing
Pain becomes more frequent and agonizing
Unilateral pain
