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- Title
TREATMENT OF TRIGEMINAL NEURALGIA WITH STEREOTACTIC RADIOSURGERY.
- Authors
Maloney-Lutz, Kathleen; Oliveri, Maureen; Gillespie, Jennifer; Tirado, Lorelyn
- Abstract
Trigeminal Neuralgia (TN) is a rare, non-malignant central nervous system condition affecting one or more branches of the fifth cranial nerve, the trigeminal nerve. The occurrence of TN is extremely rare. TN is primarily unilateral; however, there are rare cases of bilateral TN. Pain is the predominant presenting symptom, consisting of sudden, stabbing, burning, aching sensations which can become debilitating. TN is a progressive condition initially presenting with periodic attacks lasting for brief periods followed by asymptomatic periods. As TN progresses the gap between occurrences may become shorter, and the pain intensifies. Unfortunately, pain medications only provide minimal relief, if any. Stereotactic radiosurgery is an effective treatment modality for TN; however, a cisternogram is necessary for planning treatment. The CT-cisternogram examines the cisternal portion of the trigeminal nerve, which is the treatment target. Radiation oncology is seeing an increase in TN cases. Stereotactic radiosurgery offers pain relief with minimal side effects for these patients. It was determined that nurse and patient education needed to be reviewed in order to provide excellent nursing care to this increasing patient population. One radiation oncology nurse, with a background in neurology, conducted informal educational sessions for the newer nurses unfamiliar with TN. Once this education was complete, a standardized way of educating the patient was discussed. Educational sessions with the patient include the process of obtaining a CT-cisternogram to be used for treatment planning; the immobilization device the patient would wear during treatment, and the radiation treatment itself. Pain assessments occurred during each patient appointment utilizing the 0-10 Numerical Pain Rating Scale. This assessment included pain level, location, type, interventions performed and result, assessment of known triggers, and a neurological exam. Data reviewed from 2016-2021, demonstrated an increasing number of these patients receiving stereotactic radio surgery for TN, one presenting with bilateral TN. Prior to initiation of treatment, pain scores averaged 8/10. One-month post-treatment pain scores averaged 1/10, and patients described shorter episodes with longer intervals between pain occurrences. Radiation oncology nurses are integral in the care of patients with trigeminal neuralgia. Patients rely on nursing expertise to guide them from consult through to post-treatment care. The nurses continually reinforce their knowledge of TN to improve patient understanding of the entire radiation process.
- Subjects
CALIFORNIA; TRIGEMINAL neuralgia treatment; CONFERENCES &; conventions; RADIOSURGERY
- Publication
Oncology Nursing Forum, 2022, Vol 49, Issue 2, pE81
- ISSN
0190-535X
- Publication type
Article
- DOI
10.1188/22.ONF.E2