2.9 Neurological and Sensory SENSORY Flashcards
TRIGEMINAL NEURALGIA
Cause: irritation of sensory branch of 5th cranial nerve
Onset after age 40 & more common in women
TRIGGERED BY CUTANEOUS STIMULATION OF TRIGGER ZONE- CAN BE TOUCH OR TEMPERATURE
5th branch of trigeminal nerves
- ophthalmic
- maxillary
- mandibula
TRIGEMINAL NEURALGIA
Symptoms
Treatment
Symptoms: intermittent, sudden-onset severe facial pain; unilateral; + blinking, tearing, jerking; unpredictable; clusters possible
Treatment:
MEDS: neuron firing (anti-seizure meds)
NERVE BLOCKS
SURGERY
BELL’S PALSY
Cause: unknown, affects the motor aspects of the 7th CN
(facial nerve), Inflammation RT Herpes virus
Onset 20-60 yr old, any age can be affected
SUDDEN ONSET & USUALLY TEMPORARY (<6 months)
BELL’S PALSY
Symptoms
Treatment
Symptoms: unilateral, drooping of mouth, eye rolls up when closing eyelid; can have difficulty with eating; tearing
Treatment:
MEDS: steroids, analgesics, eye protection
PT/OT
HEADACHES Tension
Tension - bilateral, “pressing-tightening”, most common, mild-moderate; no triggering event. Duration 30 min – 7 days
HEADACHES Cluster
Cluster -, repeated HA over weeks or months; “sharp/stabbing”; periods of remission; swelling around eyes; congestion or tearing, awakens at night: often men 20-40 unilateral pain “behind one eye”
HEADACHES Migraine
Migraine - recurring, often unilateral, “throbbing”; family tendency. Improves with sleep. Can have N & V, photophobia and can be preceded by aura (prodromal symptoms); varied manifestations
HEADACHES
Triggers
TX
Management
Triggers: food, hormones, stress/fatigue, trauma.
TX: Meds- reduce inflammation of cerebral blood vessels & vasoconstrict, prophylaxis in freq HA sufferers, many categories of meds
Management: diary to determine triggers, treat symptoms ASAP, rest, reduce stress, R/O other brain pathology
BRAIN TUMORS
PRIMARY – arises from tissues within brain
SECONDARY – metastatic, most common
BRAIN TUMORS symptoms
Symptoms: (depend on size & location of mass) HA N & V (inc. ICP) Behavior change Muscle weakness Seizures Cognitive problems Memory Personality & mood Sensory losses Hydrocephalus
BRAIN TUMORS Treatment
Treatment: Surgery Radiation Chemo Symptom management: shunts
KEY DIAGNOSTIC PROCEDURES
EEG EMG CT SCAN MRI ANGIOGRAM LUMBAR PUNCTURE
EEG- Electroencephalography
Records electrical activity of the brain using scalp electrodes. Noninvasive.
Withhold some meds that have impact on CNS activity
No caffeine before test
EEG- Electroencephalography
Patient teaching
Patient teaching: Clean hair Check meds Records brain energy patterns NO CAFFEINE 8 hrs before test
EMG - Electromyography
Records electrical activity associated with innervation of skeletal muscle.
Needle electrodes into muscle.
Normal skeletal muscle has no electrical activity at rest.
Often done with nerve conduction studies in which stimulus is applied distally then measured proximally.
Looks at the speed of depolarization (how fast is message getting across).
