ch 60 cranial nerve disorders Flashcards
who is trigeminal neuralgia most common in (2)
- women
- pts >40 yo
S+S trigeminal neuralgia (3)
- severe unilateral pain along trigeminal nerve
- brief attacks (2-3 mins)
- can happen in clusters
triggers for trigeminal neuralgia attack (6)
- chewing
- tooth brushing
- hot/cold
- washing face
- yawning
- talking
Dx trigeminal neuralgia
-CT
Tx trigeminal neuralgia (3)
- carbamazepine (tegretol)** (antiseizure med)
- nerve block with local anesthetic
- surgery (rhizotomy, decompression)
disruption of motor branch (paralysis) of facial nerve (CN 8)
bells palsy
common ages for bells palsy
common infection preceding bells palsy
20-60 yo
HSV1
S+S bells palsy (4)
- unilateral paralysis of face
- unilateral loss of taste/ability to chew
- may have unilateral hearing loss
- inability to close eyelid
teaching for pts with bells palsy (3)
- use eyedrops
- tape eyelids shut at night
- chew on unaffected side
Tx bells palsy
(usually self resolves within 6 months)
- corticosteroids
- antivirals (valacyclovir)
syndrome: postinfectious polyneuropathy with temporary ascending paralysis caused by demyelination, usually self resolves
guillain-barre syndrome
what frequently precedes guillain-barre syndrome
infection/vaccine
S+S guillain-barre syndrome (6)
- paresthesia
- ascending paralysis/weakness
- bradycardia
- hypoTN
- facial flushing
- SIADH
complications guillain-barre syndrome (3)
- resp failure
- resp and urinary infections
- immobility
Tx guillain-barre syndrome (2)
- plasmapheresis
- IV immunoglobulin
disorder caused by GI absorption of neurotoxin caused by improperly canned/preserved foods
botulisim
S+S botulism (6)
- flaccid descending paralysis
- intact sensation
- photophobia
- blurred vision
- diplopia
- difficulty swallowing
difference between botulism and guillain-barre paralyssi
guillain-barre: ascending paralysis
botulism: descending paralysis
Tx botulism
-IV admin of botulism antitoxin
disorder : severe polyneuritis affecting spinal and cranial nerves, resulting from neurotoxin bacteria that enters through a wound (incubation 7 days)
tetanus
S+S tetanus (9)
- stiffness in jaw (trismus)**
- fever**
- severe spasms of back
- laryngeal/resp spasms
- sweating
- hyperthermia
- dysrhythmias
- seizures
- hyperreflexia
Tx tetanus (5)
PREVENTATIVE: -Dtap/Tdap vaccines MILD: -IV immunoglobulin -penicillin/doxycycline SEVERE: -sedation to control spasms (diazepam and barbiturates) -may require ventilator
how often is tetanus vaccine recommended for adults
every 10 years
