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Lesson 38. Trigeminal Neuralgia


a. Definition. Trigeminal neuralgia, also known as Tic Douloureux, is a disorder of the 5th cranial nerve (trigeminal nerve). It is characterized by sudden paroxysms of burning pain along one or more of the branches of the trigeminal nerve. The pain alternates with periods of complete comfort.

b. Signs and Symptoms.

(1) Sudden, severe pain appearing without warning. (Along one or more branches of trigeminal nerve.)
(2) Numerous individual flashes of pain, ending abruptly and usually on one side of the face only.
(3) Attacks provoked by pressure on a "trigger point" (the terminals of the affected branches of the trigeminal nerve). Such triggers include:
(a) Shaving.
(b) Talking.
(c) Yawning.
(d) Chewing gum.
(e) Cold wind.

c. Care Considerations.

(1) Instruct patient to avoid exposing affected cheek to sudden cold if this is known to trigger the nerve. For example, avoid:

(a) Iced drinks.
(b) Cold wind.
(c) Swimming in cold water.

(2) Administer drug therapy, as ordered.

(a) Tegretol or Dilantin--relieves and prevents pain in some patients.
(b) Serum blood levels of drug are monitored in long term use.
(3) Surgical procedures to sever the affected nerve provide optimum pain relief with minimum impairment.
(4) Instruct patient in methods to prevent environmental stimulation of pain.
(a) Eat foods that are easily chewed and are served at room temperature.
(b) Avoids drafts and breezes.

David L. Heiserman, Editor

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Revised: June 06, 2015