Cranial Nerve Disorders Flashcards
trigeminal neuralgia
results from degeneration or compression of artery/vein
trigeminal neuralgia occurs in who
older population, mean 50
characteristics of trigeminal neuralgia
brief paroxysms of severe neurogenic pain, stabbing/shooting, reoccurring frequently on the mandibular & maxillary distributions
unilateral
autonomic instability
what can trigger symptoms of trigeminal neuralgia
stress, cold temp
relieved by relaxation
how long do the attacks of trigeminal neuralgia last
several seconds to several minutes, followed by few minutes to hours of dull, achy pain
several attacks last days, weeks, months or longer
remission btw attacks can occur
what is also seen with trigeminal neuralgia
depression
cluster headaches
what is the major focus of examination with trigeminal neuralgia
pain - location, intensity
trigger points
triggering stimuli
motor function - control is normal
management for trigeminal neuralgia?
meds
surgery
rehab - TENS
prognosis of trigeminal neuralgia?
attacks become more frequent, easily triggered and more disabling
bell’s palsy
idiopathic facial paralysis
facial nerve CNVII
bell’s palsy is caused by what
acute inflammatory process of unknown - immune or viral - resulting in compression of the facial n within the temporal bone
bell’s palsy mainly seen in who
age 20-40
risk factors for bell’s palsy
pregnancy
preeclampsia
obesity
HTN
DM
respiratory illness
characteristics of bell’s palsy
weak/paralyzed muscles of facial expression on involved side
loss of control of salivation/lacrimation
acute onset, severe in few hrs/days
preceded by pain behind ear
how long does it take to recover from bell’s palsy
most fully recover in several weeks/months
examination of bell’s palsy
drooping of corner of mouth, eyelids that dont close
function of muscles of facial expression
taste of anterior 2/3 tongue
treatment for bell’s palsy?
meds - corticosteroids, analgesics
how do we know the facial droop presented in bell’s palsy isn’t the first sign of a stroke?
full facial paralysis is bell’s palsy due to dual innervation
rehab management for bell’s palsy
protect cornea - patching
estim to maintain tone
active facial exercise
may require sling
emotional support
eat foods that are easy to chew
prognosis of bell’s palsy
very good
show improvements within 2 weeks
proper managment - some or all facial function within 6 months
bulbar palsy
paresis or paralysis of the muscles innervated by the motor nuclei of the lower brainstem, affecting the muscles of the face, tongue, larynx, pharynx - CN IX, CN X, CN XII
what is the etiology of bulbar palsy
results of tumor, vascular or degenerative disease, malignancy, inflammation, genetic disorders, impacting lower cranial nerve motor nuclei - can be progressive
what does bulbar palsy look like
glossopharyngeal and vagal paralysis
change in voice quality - dysphonia
tongue atrophy, fasciculations
what is a possible complication of bulbar palsy
aspiration pneumonia
pseudobulbar palsy
bilateral dysfunction of corticobulbar innervation of brainstem nuclei
UMN lesion
what is the major differences between pseudobulbar palsy and bulbar palsy
psudobulbar palsy has CN5/7 involvement
emotional incontinence
tongue spasticity
spastic dysarthria
hyperactive reflexes
what is the jaw jerk reflex seen in pseudobulbar palsy
tap on jaw, contraction of masseter and temporalis muscles
what is the snout reflex seen in pseudobulbar palsy
tap on lips produces pouting of lips
