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oral path > chpt 18- facial pain and neuromusc diseases - ppt > Flashcards

chpt 18- facial pain and neuromusc diseases - ppt Flashcards

1
Q

unilateral paralysis of CN7

A

Bell’s Palsy

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2
Q

Bell’s Palsy is assoc w/what other neuromuscular disease

A

1/5 of pts w/Multiple Sclerosis also have Bell’s Palsy

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3
Q

Trigger events

A
  • occur 75% of cases and include:
  • VIRAL INFECTION (herpes)
  • EXPOSURE TO COLD
  • local/systemic infections
  • ischemia
  • acute otitis media
  • pregnancy
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4
Q

gender/age demographics for Bell’s Palsy

A
  • middle aged women (71%) > men

- in kids: secondary to viral infection, lyme disease, earache

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5
Q

Tx and prognosis for Bells Palsy

A
  • 82% recover slowly over 6mo
  • histamine, steroids, HBO, surgical decompression, ocular Abs and artificial tears
  • SELF LIMITING
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6
Q

what do neuralgias and headaches share in common

A
  • both may mimic pain of dental origin

- need to r/o dental inflammatory diseases

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7
Q

another name for trigeminal neuralgia

A

tic doulourex

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8
Q

age of onset for trigeminal neuralgia

A

avg age 50

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9
Q

what other neuromuscular disease is trigeminal neuralgia assoc with

A

4% have MS

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10
Q

name two disorders of facial pain that are associated with MS

A
  • Bell’s Palsy

- Trigeminal Neuralgia

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11
Q

Trigger points for trigeminal neuralgia

A
  • nasolabial fold
  • vermillion border
  • periorbital skin
  • alveolus
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12
Q

main branches affected by trigeminal neuralgia

A

CN V: mostly max/mand but opthalmic can also be affected

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13
Q

Criteria for Trigeminal Neuralgia Dx

A
  • abrupt attack initiated by a light touch and a specific, CONSTANT, trigger point
  • extreme paroxysmal lancinating pain
  • duration of single spasm < 2min but may repeat
  • pain is limited to 1 or more branches of CNV; NO MOTOR DEFICIT
  • trigger point refractory to additional attacks for several minutes
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14
Q

what is trigeminal neuralgia often misdiagnosed as

A

dental pain

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15
Q

What disorder is characterized by paroxysmal facial pain that is accompanied by excess lacrimation, conjunctival injection, and intense headache?

A

SUNCT syndrome

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16
Q

what does SUNCT syndrome stand for? –> EXAM

A
  • Short Lasting
  • Unilateral
  • Neuralgiform headache
  • Conjunctival injection
  • Tearing
17
Q

What CN does Glossopharyngeal Neuralgia affect

A

CN IX

18
Q

chronic pain associated w/VZV (shingles)

A

Postherpetic Neuralgia

19
Q

constant burning sensation over nerve distribution w/episodic stabbing pains

A

Postherpetic Neuralgia

20
Q

Facial paralysis seen in association with herpes zoster of the face or external auditory canal.

A

Ramsay Hunt Syndrome

21
Q

tx and prognosis for Ramsay Hunt

A
  • 82% recover completely in 6mo
  • antiviral
  • antihistamines/vasodilators
  • systemic corticosteroids
  • ocular Abs and artificial tears
22
Q

Persistent maxillofacial pain that doesn’t fit any of the more specific pain patterns that is diagnosed by exclusion of other disorders and is hard to localize and may extend to extra-oral area or may be confined to a specific area

A

Atypical Facial Pain

23
Q

gender/age demographics for Atypical Facial Pain

A

women > men

4-6th decade

24
Q

3 drugs used to tx atypical facial pain

A
  • gabapentin
  • opioid analgesic
  • TCA
25
Q

headache whose pain is behind brow-bone and/or cheekbones

A

sinus headache

26
Q

headache whose pain is in and around one eye

A

cluster headache

27
Q

headache whose pain is like a band squeezing the head

A

tension headache

28
Q

headache described by pain, nausea, and visual changes in the classic form

A

migraine

29
Q

demographics for cluster headache (gender, race, age)

A

-male > female
-3-4th decade
-blacks
familial (50x increase risk)

30
Q

unilateral pain of mid and upper face near eye, assoc w/opthalmic division of trigeminal nerve, abrupt onset, no trigger zone, recurs at same time, lasts for weeks then long remission

A

cluster headache

oral path (13 decks)

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