Trigeminal neuralgia-Bells palsy

HH assessment for TN should include

•Ear, nose, throat or dental symptoms •Sinusitis •Dental abscess •Otitis •History of 5th cranial nerve injury / herpes zoster / multiple sclerosis

physical assessment for TN should include

•Examine head, eyes, ears, nose, throat, mouth, neck, cranial nerves •Complete neuro exam

nursing physical assessment for Bell's palsy

•HEENT including all cranial nerves •One-sided paralysis of facial muscles •Paralysis of upper eyelid with loss of corneal reflex on affected side •Loss or impairment of taste over anterior portion of tongue on affected side •Increased tearing from lacrimal gland on affected side

nursing health history assessment for Bell's palsy

•Present illness •Onset of symptoms •Review Of System

manifestation of Bells palsy

rapid onset of unilateral facial weakness that occurs in few hrs, facial weakness is seen w.i 2 days. pain behind the ear, numbness of the face, tounge, ear. side face drooping, hearing deficit, loss of taste.

pt teaching for Bell's palsy

-Assist with body image disturbance (usually temporary) -wear an eye patch at nigh and protective glasses when outside -Inspect inside of mouth on affected side for food that may collect between mouth and teeth;

diagnostic studies and treatment for TN

-CT or MRI

risk factor for Bell's palsy

-DM -Hypothyroidism -AIDS -Lyme disease -syphilis

diagnostic test for Bells palsy

-EMG -MRI and CT -blood test -pt need to contact a neurologist and otolaryngologist asap

what is the cause of Bells palsy

-herpes simple virus -herpes zoster virus -viral infection -flu -mumps -rubella -genetics

nursing management for Bell;s palsy

-moist heat -gentle massage -Facial nerve stimulation via a faraday current -Protect cornea with artificial tears, sunglasses, eye patch at night and gentle intermittent closure of eye;

Trigeminal neuralgia (TN)

A chronic pain condition affecting the trigeminal nerve in the face. CN V

Bell's Palsy

ACUTE ONSET OF FACIAL WEAKNESS Due TO INFLAMMATION OF THE 7TH CRANIAL NERVE. symptoms persist over 7-10 days, most pt. have a full recovery after 6 months.

if medication treatment does not work for TN

Refer to neurology, surgery may be needed.

manifestation TN

TN1; burning, knifelike, lighting shock in the face, intense pain, facial twitching, grimacing, frequent blinking, tearing of the eye, facial sensory loss. TN2: constant aching, burning, crushing or stabbing pain.

Symptoms of TN

range from mild to severe facial pain, often triggered by chewing, speaking, or brushing the teeth. is severe facial pain triggered by cutaneous stimulation of the nerve.

what's the cause TN

constant compression of the 5th cranial nerve root, usually by a blood vessel; may be a secondary underlying problem such as MS, shingles, mass in cerebellum or brain stem.

Treatment fir TN includes

medications, injections, and surgery. -Avoiding triggers -Surgical decompression -Carbamazepine 100mg bid -Phenytoin -Gabapentin, Start with lowest dose; titrate slowly up