18 - Facial pain

Question 1

3 causes of trigeminal neuralgia

Answer 1

demyelination, expanding tumours, expanding vessels

Question 2

1st line mx for Trigeminal neuralgia

Answer 2

carbamazepine

Question 3

RF for sinusitis

Answer 3

asthma, immunosuppression, CF….

Question 4

Mx if suspicious of bacterial sinusitis?

DDx of sinusitis?

Answer 4

amoxicillin

viral (most common cause and self limiting), tumours

Question 5

what is tempro-mandibular joint dysfunction? Associations?

Mx?

Answer 5

Pain and dysfunction of mastication.
Strong psychological component.
Link to atypical facial pain and fibromyalgia.
CBT and pain relief.

Question 6

What is atypical facial pain? Associations? Mx?

Answer 6

Catch for all facial pain which doesn’t fit any other identified neuralgias.
No objective signs.
Associated with depression and anxiety.
CBT is best

Question 7

Sx of acoustic neuroma ? other name?

Can progress to what?

Answer 7

vestibular Schwannoma

unilateral hearing loss, loss of balance, tinnitus, otalgia and mass effect)

Can progress to cerebellopontine angle syndrome. With tremors and speech disturbance.