Cranial Nerve Disorders Flashcards
Trigeminal Neuralgia
Sudden unilateral severe stabbing recurrent episodes of pain in trigeminal
- women older than 40
- risks: HTN, MS, herpes, infection of teeth/jaw, brain stem infarct
- abrupt onset of paroxysms of excruciating pain
- attacks last 2-3 minutes, clustering can occur
Glycerol rhizotomy
Percutaneous procedure that consists of an injection of glycerol thru the foremen oval into try trigleminal
Percutaneous radiofrequency rhizotomy
Place needle in to the trigeminal rootlets and destroying the area with radio frequency
-result in facial numbness
Micro vascular decompression
Displacing and repositioning blood vessels
- for trigeminal
- dangerous as near the brain stem
Bell’s Palsy
Disruption of facial nerve (VII) on one side of the face
- considered benign with full recovery after 6 months
- forehead not wrinkled, eyeball rolls up, eyelid does not close, paralysis of lower face
- Dx: EMG
Bell’s palsy treatment
- moist heat, gentle massage
- electrical stimulation of nerve
- corticosteroids, HSV treatment, eyecare
Guillain-Barré syndrome
Acute, rapidly,progressive, and potential fatal polyneuritis
- ascending symmetric paralysis
- loss of myelin and edema
- preceded by viral infection, trauma, surgery, HIV, viral immunization
- Camp is most recognize organism
GBS manifestations
Develop 1-3 weeks added upper respiratory or GI infection
- weakness of lower extremities: peaks at day 14
- paresthesia: hypotonia and arerlexia
- orthostatic hypotension, HTN, abnormal vagal responses
- can have SIADH
- most serious complication: respiratory failure
GBS Dx
Patient history
CSF
EMG
GBS
- ventilatory support during acute phase
- plasmapheresis: first 2 weeks
- IV of high dose immunoglobulin
- after 3 week neither has value
Botulism
Serious type of food poisoning
- absorption of neurotoxin
- improper home canning, foods with low acid content
- descending flaccid paralysis
- IV of botulinum antitoxin
Tetanus
Lockjaw, polyradiculitis and polyneuritis
- due to neurotoxin from soil, mold, and manure
- incubation: usually 7 days
- slight fever, symptoms of infection, tonic spasms
- progresses: rigidity of neck, back, abdomen, and extremities
Tetanus care
Toxoid booster and TIG
Clean wounds with soap and water
Spasm control by deep sedation (diazepam) and neuromuscular blocking agents (severe cases)
10-14 days of penicillin, tetracycline, or doxycycline
Trach early and maintained on mechanical ventilation
