Trigeminal Neuralgia (Tic Douloureux)

- Condition affecting the 5th cranial nerve

- Characterized by unilateral paroxysm of shooting and stabbing pain in the area affected by the
second and third branches of the trigeminal nerve.
- Pain episodes can be described as abrupt, lasting from a few second and minutes, and producing
contraction of some of the facial muscles
- More common in females fifty years old and above

ASSESSMENT AND DIAGNOSTIC METHOD

Diagnosis is based on characteristic behaviour: avoiding stimulating trigger point areas

MANAGEMENT

Pharmacologic Therapy

Ant seizure agents Carbamazepine (Tegretol) and Phenytoin (Dilantin)

Surgical Management

Percutaneous Radiofrequency Trigeminal Gangliolysis – best choice

Microvascular Decompression

Percutaneous Balloon Neurocompression

NURSING INTERVENTION

Monitor patient for bone marrow depression during long term carbamazepine therapy

Monitor patient for phenytoin side effects,including nausea, dizziness, nystagmus, somnolence,
ataxia, gum hyperplasia and skin rushes or eruptions

Assist patient to recognize the factors that rigger the excruciating pain. Teach patient how to lessen
these discomforts by using cotton pads and room temperature water to wash face

Instruct patient to rinse mouth after eating when tooth brushing causes pain

Advise patient to take food and fluids at room temperature to chew on unaffected side and to ingest
soft food
Recognize that anxiety, depression and insomnia often accompany chronic painful conditions and
use appropriate interventions and referrals

Provide postoperative care by performing neurologic checks to assess facial motor and sensory
deficits