ch 60 cranial nerve disorders

Question 1

who is trigeminal neuralgia most common in (2)

Answer 1

• women

- pts >40 yo

Question 2

S+S trigeminal neuralgia (3)

Answer 2

• severe unilateral pain along trigeminal nerve
• brief attacks (2-3 mins)
• can happen in clusters

Question 3

triggers for trigeminal neuralgia attack (6)

Answer 3

• chewing
• tooth brushing
• hot/cold
• washing face
• yawning
• talking

Question 4

Dx trigeminal neuralgia

Answer 4

-CT

Question 5

Tx trigeminal neuralgia (3)

Answer 5

• carbamazepine (tegretol)** (antiseizure med)
• nerve block with local anesthetic
• surgery (rhizotomy, decompression)

Question 6

disruption of motor branch (paralysis) of facial nerve (CN 8)

Answer 6

bells palsy

Question 7

common ages for bells palsy

common infection preceding bells palsy

Answer 7

20-60 yo

HSV1

Question 8

S+S bells palsy (4)

Answer 8

• unilateral paralysis of face
• unilateral loss of taste/ability to chew
• may have unilateral hearing loss
• inability to close eyelid

Question 9

teaching for pts with bells palsy (3)

Answer 9

• use eyedrops
• tape eyelids shut at night
• chew on unaffected side

Question 10

Tx bells palsy

Answer 10

(usually self resolves within 6 months)

• corticosteroids
• antivirals (valacyclovir)

Question 11

syndrome: postinfectious polyneuropathy with temporary ascending paralysis caused by demyelination, usually self resolves

Answer 11

guillain-barre syndrome

Question 12

what frequently precedes guillain-barre syndrome

Answer 12

infection/vaccine

Question 13

S+S guillain-barre syndrome (6)

Answer 13

• paresthesia
• ascending paralysis/weakness
• bradycardia
• hypoTN
• facial flushing
• SIADH

Question 14

complications guillain-barre syndrome (3)

Answer 14

• resp failure
• resp and urinary infections
• immobility

Question 15

Tx guillain-barre syndrome (2)

Answer 15

• plasmapheresis

- IV immunoglobulin

Question 16

disorder caused by GI absorption of neurotoxin caused by improperly canned/preserved foods

Answer 16

botulisim

Question 17

S+S botulism (6)

Answer 17

• flaccid descending paralysis
• intact sensation
• photophobia
• blurred vision
• diplopia
• difficulty swallowing

Question 18

difference between botulism and guillain-barre paralyssi

Answer 18

guillain-barre: ascending paralysis

botulism: descending paralysis

Question 19

Tx botulism

Answer 19

-IV admin of botulism antitoxin

Question 20

disorder : severe polyneuritis affecting spinal and cranial nerves, resulting from neurotoxin bacteria that enters through a wound (incubation 7 days)

Answer 20

tetanus

Question 21

S+S tetanus (9)

Answer 21

• stiffness in jaw (trismus)**
• fever**
• severe spasms of back
• laryngeal/resp spasms
• sweating
• hyperthermia
• dysrhythmias
• seizures
• hyperreflexia

Question 22

Tx tetanus (5)

Answer 22

PREVENTATIVE: 
-Dtap/Tdap vaccines
MILD: 
-IV immunoglobulin
-penicillin/doxycycline
SEVERE: 
-sedation to control spasms (diazepam and barbiturates)
-may require ventilator

Question 23

how often is tetanus vaccine recommended for adults

Answer 23

every 10 years