Causes and symptoms of Trigeminal Neuralgia

One of the twelve cranial head nerves, Trigeminal nerve is the supplier to the upper eye lid and the lower chin. A disorder of this nerve supply causes facial pain and headache, the symptoms of which are classified as Trigeminal Neuralgia.  The nerve disorder is also known as tic douloureux.

Causes of Trigeminal Neuralgia

Although no clear cut reasons for the symptoms of nerve disorder have been suggested but physicians suggest the following possible reasons.

1. Physicians are of the belief that the symptoms of the nerve disorder start to appear when the nerves passing through the openings of the skulls to the face, get subjected to shocking changes. This causes demyelination of the nerve cell. Demyelination is the term used to describe the compression of the cell as a result of loss of conductive coating over the cells. This exposes the nerve fibres to irritation or pain as a result of compression by other larger nerves or blood vessels.
2. Biochemical changes in the nerve cells might also be the cause of pain and facial nerve disorder.
3. Doctors also suggest that the facial nerves get compressed by an abnormally sized blood vessel. This causes damage of the nerve cells leading to pain and some times inflammation.
4. Clinical tests conducted at the period of extreme pain suggest that the Trigeminal Neuralgia symptoms are caused when the inner nerve fibres of the cranial nerve, called axon, gets damaged due to trauma or shock.

Symptoms of Trigeminal Neuralgia

The syndrome of Trigeminal Neuralgia can be identified by the following symptoms.

1. The syndrome has small trigger zones on the face, like the cheek, nose and the lip that when stimulated causes a typical explosion of pain. This trigger might be caused due to any of he following stimulations-
1. A slight touch to the trigger zone.
2. Eating and chewing processes also subject the nerve to trigger off pain.
3. Common routine activities like washing face, brushing, talking etc.
4. Adverse weather conditions like windy and cold weather or very hot weather with loo hitting the face.
2. The syndrome has several related health implications. For example the short burst of pain makes people stop taking food and this leads to malnutrition, weight loss and dehydration.
3. The bursts of pain become unbearable but in the periods between the pain, patients remain pain free. A slight continuous aching has however been reported by many patients.

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Understanding CAUTI

CAUTI stands for Catheter Associated Urinary Tract Infection. CAUTI is a common affliction today and is the second most common cause of bloodstream infection. The diagnosis of CAUTI is based on finding bacteriuria; along with an enhanced white blood cell count (WBC) based examination and analysis of the patient’s urine.

Symptoms of CAUTI –

• Increased serum WBC

• Burning pain in the area of the urethra, flank or the bladder
• Fever or chills
• Malaise
• Offensive urine odour
• Change in color and character of urine, it might become cloudy or have more sediments
• Hematuria
• Bladder spasms / leakage
• Catheter obstruction
• The increase in weakness or spasticity in patients who are already suffering from any neurological disease or disorder
• Change in mental frame of mind in young as well as old, but more in the latter, such as, lethargy, , delirium, or subtle changes in behavior
• Bacteraemia (especially after trauma to the urinary mucosa)

So what are the risks associated with CAUTI?

Research studies have indicated that factors like history of previous catheter use, the duration the catheter is in situ , the length of hospital stay before catheter insertion, the reason for and location of catheter insertion are all risks associated with this infection. The direct relation between the duration the catheter is in suit and the development of CAUTI is quite well established and accepted. Some other innate risk factors such as increasing age, gender and general debilitation are also associated with this infection.

CAUTI can be prevented by implementing the following initiatives:

• Insert catheters only for appropriate indications.
• Remove unnecessary catheters.
• Perform hand hygiene in compliance with CDC or WHO.
• Provide education on proper insertion and maintenance.
• Limit insertion of catheters to trained personnel.
• Insert catheters using aseptic technique and sterile equipment.
• Ensure that the indwelling catheters are secured well after insertion so that it does not move or shift and to prevent urethral traction.
• Make sure that the drainage is closed.
• Maintain unobstructed urine flow.
• Cleaning the metal area with antiseptic solutions and ensure routine hygiene.
• Make sure that the catheter is removed within 48 hours of surgery
• Implement and promote alternatives to indwelling urinary catheterization

The world has woken up to this infection that’s spreading like wild fire and has started taking some positive steps in the awareness initiative. Awareness is leading to prevention tips that if followed will help reduce the occurrence of CAUTI to a great extent.

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