A disorder of fifth cranial nerve?

Appeared in: VSSC Nursing Officer - 2021

Explanation

Trigeminal neuralgia is a chronic pain condition that affects the trigeminal nerve, which is the fifth cranial nerve (CN V).
The trigeminal nerve is responsible for providing sensation to the face and controlling motor functions such as biting and chewing.
The hallmark of this condition is sudden, severe, and debilitating facial pain, often described as an electric shock, which is typically unilateral.

Option B: Bell's palsy is a disorder of the seventh cranial nerve (Facial Nerve, CN VII), not the fifth.
Option C: Myasthenia gravis is an autoimmune disorder affecting the neuromuscular junction, leading to muscle weakness. It is not a primary disorder of a single cranial nerve.
Option D: Nerve deafness, or sensorineural hearing loss, is related to pathology of the inner ear or the eighth cranial nerve (Vestibulocochlear Nerve, CN VIII).

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Disorders of the Cranial Nerves as background academic context rather than a clinical decision trigger.
Nursing care for a patient with trigeminal neuralgia is centered on pain management and patient education to avoid triggers. This includes advising a soft diet, maintaining oral hygiene carefully, and protecting the face from cold drafts.
The first-line medication is often an anticonvulsant like Carbamazepine. Nurses must educate patients on its use, the importance of adherence, and monitoring for side effects like dizziness or blood dyscrasias.
What if? If the patient presented with unilateral facial drooping, inability to close an eye, and loss of taste, but without the characteristic severe pain, the diagnosis would more likely be Bell's palsy (Cranial Nerve VII).

How to Approach the Question

Identify the core of the question, which is to name a disorder of the 'fifth cranial nerve'.
Recall or deduce the name of the fifth cranial nerve, which is the Trigeminal nerve.
Examine the options. The term 'Trigeminal neuralgia' directly incorporates the name of the nerve, making it the most probable answer.
Confirm the answer by mentally ruling out the other options. Associate Bell's palsy with the 7th nerve (facial), nerve deafness with the 8th nerve (vestibulocochlear), and Myasthenia gravis with the neuromuscular junction, not a specific cranial nerve disorder.

Concept Tested & Keywords

QofFaLaqWXkjUpHAeHkXjY

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 140-142

E6 Medicine Harrison 22e Part 2 p. 1457-1459

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