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HUD > Neruological Pathology > Flashcards

Neruological Pathology Flashcards

1
Q

What is Bell’s palsy?

A

The most common cause of facial nerve paralysis

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2
Q

What is the pathogenesis for Bell’s palsy?

A

Latent herpes virus is reactivated
Inflammation of the nerve

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3
Q

What is the difference between LMN and UMN facial palsy?

A

LMN weakness - whole side of face
UMN weakness - spares forehead muscles, due to stroke or cerebral tumour

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4
Q

What are some other causes of LMN facial palsy?

A

Tumours
Ear infections
Ramsay hunt syndrome
Melkerssons syndrome

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5
Q

What are clinical features of Bell’s palsy?

A

Ear pain
Facial weakness and stiffness
Altered taste
Distortion of sound

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6
Q

What is the treatment for Bell’s palsy?

A

Recover by yourself in 1-2 months
Prednisolone and acyclovir prevent

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7
Q

What is the dental relevance of Bell’s palsy?

A

Parotid tumour facial palsy
Misdirected ID block facial palsy

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8
Q

What is trigeminal neuralgia?

A

Sudden stabbing recurrent pain in trigeminal nerve
30 seconds
No facial weakness or sensory
Electric shock pain

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9
Q

What causes trigeminal neuralgia?

A

Random action potentials from light touch
Blood vessels compressed trigeminal nerve
Secondary to MS, brain lesion

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10
Q

What are the clinical features of trigeminal neuralgia?

A

Spasms of facial pain
Radiates from corner of mouth to ear
Light touch, chewing, shaving, cold wind
Hundreds of times a day

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11
Q

What is the dental relevance of trigeminal neuralgia?

A

Confused with dental pain
Bupivacaine block gives relief

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12
Q

What is the treatment for trigeminal neuralgia?

A

Carbamazepine - controls pain
Cryotherapy
Open cranial surgery

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13
Q

What is a stroke?

A

Sudden neurological disturbance due to blockage or rupture of brain blood vessel
Lasts longer that 24 hours

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14
Q

What are the different incidences of a stroke?

A

Minor stroke - full recovery in less than a week
Stroke in evolution - worsening symptoms
Completed stroke - neuro defecit at its worst

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15
Q

What are the 3 main types of stroke?

A

Ischaemic
Haemorrhagic
Subarachnoid haemorrhage

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16
Q

What is an ischaemic stroke?

A

Blockage of brain stem by embolus from atheroma

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17
Q

What can an ischaemic stroke result in?

A

Horners syndrome
Pseudobulbar palsy

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18
Q

What is the treatment of an ischaemic stroke?

A

Aspirin 150mg daily
Surgery for carotid artery

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19
Q

What is a haemorrhagic stroke?

A

Intracerebral bleed
Less common
Visible on CT scan

20
Q

Who is at risk of a haemorrhagic stroke?

A

Hypertensives
Coagulation disorders
Genetic

21
Q

What is a subarachnoid haemorrhage?

A

Rupture of blood vessel into cerebrospinal fluid in subarachnoid space
Circle of Willis berry aneurysm

22
Q

What are signs and symptoms of a subarachnoid haemorrhage?

A

Severe headache
Pain on knee extension
Unconscious

23
Q

What is the treatment for subarachnoid haemorrhage?

A

Neuro surgery

24
Q

What are the main risk factors for a stroke?

A

Atheroma
Diabetes
Smoking alcohol
High RBC

25
Q

What are the telling symptoms for a stroke?

A

Starts with a bad headache no cause
Numbness of face arm leg
Confusion
Slurred speech
Nausea = haemorrhagic

26
Q

What is the dental relevance of a stroke?

A

Anti platelet medication
Weakness of facial area
Swallowing
Communication
Mobility

27
Q

What is epilepsy?

A

CNS disorder with seizures

28
Q

What are the 2 types of seizures in epilepsy?

A

Generalised (whole brain):
Tonic-clinic
Absence - children
Myoclonic- jerks of limbs
Focal:
Simple - consciousness okay
Complex - brain
From tumours, infarction

29
Q

What is the treatment for epilepsy?

A

Anti epileptic drugs
IV, epistatus for prolonged seizure

30
Q

What is the dental relevance of epilepsy?

A

Xerostomia
Delayed healing
Risk of infection
Excessive bleeding
Gingival hypertrophic

31
Q

How do you manage an epileptic emergency?

A

Protect airway
Examine for dental trauma
Do not treat
Escort home

32
Q

What is dementia?

A

Deterioration of memory
No disturbance of consciousness

33
Q

What is the cause of dementia?

A

Alzheimer’s
Neurofibrillary tangles and plaques in brain

34
Q

What drugs can be used to treat dementia?

A

Anticholinesterases
Anticonvulsants

35
Q

When is dementia reversible?

A

Tumour
Intracranial lesions
Depression
B12, folate, thyroxine deficiency

36
Q

What is Parkinson’s?

A

Idiopathic disorder
Resting tremor
Rigidity

37
Q

What is the pathology of Parkinson’s?

A

Degeneration of basal ganglia
Loss of dopamine
Levy bodies

38
Q

What can cause Parkinson’s?

A

Drugs alcohol
Stroke
Trauma
Ptsd

39
Q

What are the treatments for Parkinson’s?

A

Dopamine agonists
Amanda dine
Anticholinergics - tremor

40
Q

What is the dental relevance of Parkinson’s?

A

Do not interrupt medication
Difficulty swallowing
Aspiration

41
Q

What is multiple sclerosis?

A

Causes attacks of neurological disturbance
Demyelination in CNS
Not periphery

42
Q

What are the clinical features of MS?

A

Loss of vision
Spinal cord lesions
Brain stem lesions
Pins and needles

43
Q

What are the 3 types of MS?

A

Relapsing remitting - attack and full recovery
Primary progressive - gradual decline in function
Secondary progressive - one episode, remission, reoccurance

44
Q

What is the treatment for MS?

A

IV oral steroids
ACTH
Muscle relaxants
Anticholinergics

45
Q

What is the dental relevance of MS?

A

Avoid NSAIDs
Increased risk of infection

46
Q

Wat are the 2 types of head injury?

A

Extradural - blood between skull and dura mater, defined margin on CT
Subdural- blood between dural and arachnoid layer of meninges, CT widespread irregular margin

HUD (16 decks)

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