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Oral Pathology, Stephen > chpt 18- facial pain and neuromuscular disease > Flashcards

chpt 18- facial pain and neuromuscular disease Flashcards

1
Q

3 symptoms with dysfunction of motor nerves

A

Lack of motion
Weakness
Loss of function

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2
Q

loss of sensation

A

anesthesia

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3
Q

partial loss of sensation

A

hypoesthesia

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4
Q

change of sensation

A

paresthesia

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5
Q

increased sensation

A

hyperesthesia

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6
Q

CN VII (facial nerve) is mostly ____ with some ____

A

mostly motor with some sensory

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7
Q

unilateral paralysis of CN VII

A

Bell’s Palsy

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8
Q

What systemic disease has a high rate of Bell’s palsy

A

Multiple Sclerosis

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9
Q

75% of Bell’s palsy caused how

A

trigger event (viral infection, exposure to cold, pregnancy)

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10
Q

Is it called Bell’s palsy if the the paralysis is secondary to surgical or traumatic severance of the nerve

A

no

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11
Q

Syndrome that can have Bell’s Palsy associated

A

Melkesson – Rosenthal

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12
Q

Demographic for Bell’s Palsy

A

middle aged

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13
Q

What is usually cause of Bell’s Palsy in children

A

Secondary to viral infection, Lyme disease, or earache

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14
Q

Clincial appearance of Bell’s Palsy

A

mask like appearance, inability to smile, close one eye or wink, raise one eyebrow, corner of mouth droops

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15
Q

Is there a universal treatment for Bell’s Palsy

A

no

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16
Q

what is the recovery rate for Bell’s Palsy

A

82% recover slowly within 6 months

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17
Q

these may mimic pain of dental origin so must rule out dental inflammatory disease

A

neuralgias and headaches

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18
Q

How will patients act/feel with neuralgias and headaches

A

confused, frustrated, afraid

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19
Q

Called Tic douloureux, affecting the trigeminal nerve (CN V)

A

trigeminal neuralgia

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20
Q

Symptoms of Tic Douloureux/ Trigeminal Neuralgia

A

extremely severe, electric shock, sharp, lancinating pain in one or more trigeminal branches

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21
Q

Most common of all the neuralgias

A

tic douloureux/trigeminal neuralgia

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22
Q

3 divisions of CN V

A

ophthalmic (i)
maxillary (ii)
mandibular (iii)

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23
Q

trigeminal neuralgia most commonly involves which branches

A

mostly middle (maxillary) and lower (Mandibular), but can be all 3 divisions

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24
Q

Criteria diagnosis of trigeminal neuralgia/tic douloureux

A

abrupt attack, initiated by a light touch and specific, constant trigger . Duration of single spasm <2 min

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25
Q

Is there motor deficit in trigeminal neuralgia/tic douloureux

A

No

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26
Q

What can decrease pain in trigeminal neuralgia/tic douloureux

A

Carbamazepine

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27
Q

Common trigger point for trigeminal neuralgia/tic douloureux

A

nasolabial folds
Vermillion border
Periorbital skin

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28
Q

Treatment for trigeminal neuralgia/tic douloureux

A

topical/systemic meds
Decompress nerve
Destroy nerve

29
Q

If paroxysmal facial pain is accompanied by excess lacrimation, conjunctival injection, and intense headache, what should be considered instead of trigeminal neuralgia/tic douloureux

A

SUNCT syndrome

30
Q

What does SUNCT syndrome stand for

A 
S = Short lasting 
U = unilateral
N = Neuralgiform headache 
C = conjuctival injection
T = Tearing
31
Q

Similar to trigeminal neuralgia except that the 9th CN is affected

A

Glossopharyngeal Neuralgia

32
Q

What are the anatomical locations for Glossopharyngeal Neuralgia that is different from trigeminal neuralgia/tic douloureux

A

intra-auricular area, tonsil, base of tongue, posterior mandible, lateral wall pharynx

33
Q

If pt has neuralgia triggered by talking, chewing, or swallowing

A

Glossopharyngeal Neuralgia

34
Q

Chronic pain associated with Vericella-Zoster virus/ Shingles characterized by constant burning sensation over nerve distribution with episodic stabbing pains

A

Postherpectic Neuralgia

35
Q

Facial paralysis seen in association with herpes zoster of the face or external auditory canal also associated with facial paralysis, hearing deficits, vertigo, and other auditory and vestibular symptoms

A

Ramsay-Hunt Syndrome

36
Q

Treatment options for Ramsay Hunt syndrome

A

antiviral meds (acyclovir)
Antihistamines or vasodilators
Systemic corticosteroids
Ocular antibiotics and artificial tears

37
Q

What is the recovery rate for Ramsay Hunt Syndrome

A

82% of pts recover completely in 6 months

38
Q

persistent maxillofacial pain that doesn’t fit any of the other patterns (diagnosis by exclusion), but need to rule out sinus problems, cracked tooth, headache, infection, ischemia, myofascial pain, typical neuralgias, TMD, trauma, or tumors

A

atypical facial pain

39
Q

Demographics for atypical facial pain

A

women> men, 40-50 y.o.

40
Q

3 treatments of atypical facial pain

A

Gabapentin (anticonvulsants)
Opiod analgesics
Tricyclic antidepressants

41
Q

degeneration and death of marrow and bone from a slow or abrupt decrease in marrow blood flow, will not be picked up on radiograph, only way to diagnose is to inject bone marrow with local anesthetic

A

Neuralgia – Inducing Cavitational Osteonecrosis

42
Q

Treatment for Neuralgia-Inducing Cavitational Osteonecrosis

43
Q

4 types of headaches

A

Sinus
Cluster
Tension
Migraine

44
Q

pain is behind browbone and/or cheekbones

A

sinus headache

45
Q

pain is in and around the eye

46
Q

pain is like a band squeezing head

47
Q

pain, nausea, visual changes

48
Q

Males> females, 30-40y.o., called an alarm clock headache with vasodilation related to head trauma, abnormal hypothalamic function

A

cluster/alarm clock headache

49
Q

demographic for Cluster/alarm clock headaches

A

African-Americans, 80% smokers

50
Q

Character of Cluster headaches

A

upper face near eye, abrupt onset, no trigger zone, recurs at same time, lasts for weeks then has long remission

51
Q

What nerve and how is the Cluster headache associated

A

unilateral associated with ophthalmic division Trigeminal

52
Q

2 types of migraine (disabling unilateral headache)

A

migraine with aura

Migraine without aura

53
Q

vasospasm/vasoconstriction of cerebral arteries in response to reduced serotonin activity followed by vasodilation

54
Q

Demographic for migraines

A

women more effected and more severly

55
Q

Best treatment for migraines

A

recognize and avoid triggers

56
Q

4 meds for migraines

A

ergotamine
Beta blockers
Serotonin receptor agonists

57
Q

pain/burning sensation in mouth including gingival, unattached mucosa and tongue, found in post- menopausal women, with a strong associating with depression and anxiety. Will build in intensity and can have altered taste

A

Burning mouth syndrome

58
Q

technical name for burning mouth syndrome and is there one known cause

A

Glossopyrosis, multiple causes, multiple treatments

59
Q

Capasin treatment for Glossopyrosis

A

swish red hot sauce

60
Q

Persistent abnormal taste

61
Q

75% of taste is

62
Q

injury to auriculotemporal nerve leads to flushing and sweating along its distribution after gustatoary stimuli. Can occur as a result of parotidectomies

A

Frey syndrome/auriculotemporal syndrome/gustatory sweating

63
Q

autoimmune nonsupparative inflammatory destruction of joings due to cross reacting antibodies, usually have symmetrical large joints

A

Rheumatoid arthritis

64
Q

Wear and tear inflammation leading to destruction of cartilage, then bone

A

osteoarthritis/degenerative joint

65
Q

Only bone in the body that has to cross the midline and work in unison with the other side

66
Q

TMD is a problem of what part of masticatory system

A

entire masticatory system (teeth, jaws, joints, muscles)

67
Q

TMD that is associated with dysfunction more than pain, having a clicking, popping, disarticulation or lack of opening

A

arthrogenic disorders

68
Q

Conservative treatments of TMD

A 
rest
Heat/cold 
Immobilize
Occlusal splint 
Occlusal adjustment 
Physical therapy

Oral Pathology, Stephen (13 decks)

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