Bells Palsy + Trigeminal Neuralgia Flashcards
(24 cards)
what are 2 causes of peripheral neuropathy?
side effect of medication
systemic disease
a generalized process affecting many peripheral nerves, with the distal nerves usually affected most prominently
polyneuropathy
any disorder of the peripheral nervous system
peripheral neuropathy
refers to disorders of the central and peripheral nervous system
neuropathy
pathology affecting an individual peripheral nerve
mononeuropathy
what is the most common cause of mononeuropathy?
compression of the nerve
acute peripheral facial nerve palsy
bells palsy
what is the most common cause of bells palsy?
viral inflammatory/immune reaction
what is the onset of bells palsy?
sudden (usually over hours)
how do you differentiate between bells palsy and stroke?
eyebrow sag in bells palsy
a patient presents with unilateral facial paralysis, eyebrow sagging, inability to close the eye, and disappearance of the nasolabial fold. Dx? and treatment? (3)
bells palsy
prednisone
OTC artificial tears
night eye ointment/protective glasses
when does bells palsy reach maximal clinical weakness/paralysis?
within 3 weeks from the first day of visible weakness
when does bells palsy reach recovery or some degree of function?
within 6 months
what diagnostic can be used for bells palsy to determine prognosis?
EMG
what treatment can be added for severe bells palsy?
valacyclovir
which cranial nerve is involved with trigeminal neuralgia? which 2 branches?
CN V (5)
maxillary (v2) + mandibular branch (v3)
what is the most common etiology of trigeminal neuralgia?
compression of trigeminal nerve root by artery or vein
what causes the symptoms of trigeminal neuralgia?
compression, leading to circumscribed area of demyelination
a patient presents with brief episodes of severe, stabbing focal pain unilaterally in the distribution of the affect branch. Dx? Treatment? (2)
trigeminal neuralgia
carbamazepine/oxcarbazepine
baclofen/lamotrigine
what is trigeminal neuralgia triggered by? (3)
touch
movement
eating
what secondary causes should be ruled out if a patient presents with trigeminal neuralgia? (3)
structural brain lesion
multiple sclerosis
vascular cause
what diagnostic can be used for trigeminal neuralgia to rule out secondary causes? (2)
MRI/MRA
what are other interventions for trigeminal neuralgia for patients who are non-responsive to meds?
microvascular surgical decompression
radiofrequency rhizotomy
gamma knife radiosurgery
what treatment can be used for elderly patients with trigeminal neuralgia who are non-responsive to meds?
radiofrequency rhizotomy
