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BDS 2: CHHD > Neurology > Flashcards

Neurology Flashcards

1
Q

Name some common neurological complaints (9)

A
  • Cerebrovascular accidents - Epilepsy
  • Headaches / orofacial pain
  • Meningitis
  • Trigeminal neuralgia
  • Herpes Zoster
  • Multiple sclerosis
  • Parkinsonism
  • Tumours
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2
Q

What is the most common neurological complaint?

A

Headaches / Orofacial pain

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3
Q

What can cause Headaches / Orofacial pain? (5)

A
  • Local disease
  • Vascular disease
  • Referred pain
  • Neurological disorders
  • Psychogenic disorders
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4
Q

What is the most likely cause of a migraine?

A

Likely caused by intra and extracranial blood vessels dilatation and inflammation

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5
Q

Name some common triggers of a migraine

A
  • Stress
  • Caffeine
  • Alcohol
  • Weather
  • Certain foods
  • Low blood sugar
  • Bright light
  • Lack of sleep
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6
Q

How would you manage acute migraine attacks?

A

With use of Triptans

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7
Q

How would you manage recurrent frequent migraine attacks?

A

With use of a B-blocker

E.g. Propanolol

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8
Q

What are some associated signs/symptoms of a migraine? (4)

A
  • Nausea
  • Vomiting
  • Photophobia (light sensitivity)
  • Phonophobia (sound sensitivity)
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9
Q

Who are mainly affected by Migrainous neuralgia?

A

Middle aged men

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10
Q

What is Migrainous neuralgia commonly know as?

A

Cluster headaches

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11
Q

Migrainous neuralgia causes unilateral pain where? (4)

A

Unilateral pain around the;

  • Eye
  • Frontal area
  • Cheek
  • Temporal area
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12
Q

Besides unilateral pain name some symptoms of Migrainous neuralgia (4)

A
  • Ipsilateral lacrimation
  • Photophobia
  • Nasal stuffiness
  • Rhinorrhorea (runny nose)
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13
Q

Name 3 ways in which Migrainous neuralgia is managed

A
  • High flow oxygen
  • Triptans
  • Verapamil
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14
Q

Name some serious causes of headache (7)

A
  • Acute glaucoma
  • Acute hypertension
  • Brain tumours
  • Giant cell arteritis
  • Meningitis
  • Subarachnoid haemorrhage
  • Subdural or epidural haemorrhage
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15
Q

Define a stroke

A

Syndrome consisting of rapidly developing symptoms/signs of loss of focal CNS function

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16
Q

What are the 2 vascular mechanisms that cause stroke

A
  • Ischaemic

- Haemorrhagic

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17
Q

What directly causes a stroke?

A

Atherosclerosis in carotid or intracerebral arteries

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18
Q

Name some risk factors of a stroke

A
  • Hypertension
  • Diabetes mellitus
  • Hyperlipidaemia
  • Heart disease
  • Atrial Fibrillation
  • Excess alcohol
  • Smoking
  • Carotid artery occlusion
  • Polycythaemia vera
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19
Q

What is the acronym to see if someone is suffering from a stroke

A
  • FAST
  • Face drooping
  • Arms weakness
  • Speech slurred
  • Time to call 999
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20
Q

How do you investigate a stoke?

A
  • Assess patients risk factors

- CT Scan

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21
Q

How would you treat a stroke?

A

300mg Aspirin to be administered within 48 hours of onset

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22
Q

What are things you may need to recognise a patient with a stroke may have? (3)

A
  • Impaired mobility and communication (speak slowly and clearly)
  • Likelihood of oral hygiene deterioration on the paralysed side (recommend electric toothbrush)
  • Need for modifications during dental treatment (upright position with extra care)
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23
Q

As a dentists what should you monitor for a patient with a history of stroke? (2)

A
  • Blood pressure

- Anticoagulation status

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24
Q

What are Transient Ischaemic Attacks most commonly caused by?

A

Thromboembolism from an atheroma in the carotid vessels

25
Q

What occurs during a Transient Ischaemic Attack?

A

Manifest as sudden loss of focal CNS function

26
Q

How long does a Transient Ischaemic Attack typically last?

A

A few minutes

27
Q

What are some risk factors of a Transient Ischaemic Attack? (5)

A
  • Smoking/Alcohol
  • Hypercholesterolaemia
  • Atrial fibrillation/Valvular disease
  • Hypertension
  • Diabetes Mellitus
28
Q

What is Parkinson’s disease?

A

Degenerative conditions primarily affecting the substantia nigra of the basal ganglia where dopamine is the neurotransmitter

29
Q

Parkinson’s depletes dopamine levels, what does this cause?

A

Loss of dopamine leads to less stimulation of the motor cortex and slower
onset of movements

30
Q

When to Parkinson’s disease symptoms appear?

A

When 60-80% of dopaminergic neurons are lost

31
Q

What is Akinesia?

A

Loss or impairment of the power of voluntary movement

32
Q

What is Gait?

A

Flexed or stooped ape-like posture, reduced arm swing, postural instability

33
Q

What are some clinical features of someone with Parkinson’s?

A
  • Akinesia
  • Gait
  • Tremor/Rigidity
34
Q

Parkinson’s disease is treated by enhancing dopaminergic pathways. What are the ways in which it is done? (5)

A
  • Dopamine replacement
  • Dopamine agonist
  • Blocks Dopamine metabolism
  • Inhibitors of Dopamine and L-Dopa breakdown
  • Anticholinergics
35
Q

What as a dentist should you consider when treating a patient with Parkinson’s?

A
  • Blankness of expression and apparent unresponsiveness not mistaken for
    lack of reaction or intelligence
  • Minimise anxiety as it increases tremor which may affect tongue/lip
  • Avoid LA
36
Q

What is multiple sclerosis?

A

Chronic relapsing neurological disorder affecting young adults

(Demyelination disease)

37
Q

What is the Female:Male in multiple sclerosis?

A

3:1 (more common in females)

38
Q

When can Multiple sclerosis develop?

A

At any age

Rare in children/elderly

39
Q

What climate has the highest incidence of multiple sclerosis?

A

Tropical climates

40
Q

What type of disease is Multiple sclerosis thought to be?

A

Autoimmune disease in genetically susceptible individuals

41
Q

What does multiple sclerosis affect? (3)

A
  • White matter of the brain
  • Spinal cord
  • Optic nerves
42
Q

What are the consequences of multiple sclerosis? (2)

A
  • Reduction in conduction velocity

- Loss of information conveyed

43
Q

What are the 3 aspects of multiple sclerosis treatment?

A
  • Management of an acute relapse
  • Modification of the disease course
  • Control of symptoms
44
Q

As a dentist what should be considered when treating a patient with multiple sclerosis?

A
  • Short appointments (unable to open mouth for long time)
  • Treat in morning so less fatigue
  • Treat upright
45
Q

What are some oral manifestations suggestive of advanced multiple sclerosis?

A
  • Trigeminal neuralgia
  • Facial palsy
  • Facial pain
  • Difficulty swallowing
  • Higher incidence of dental diseases
46
Q

What is Epilepsy?

A

Recurrent occasional, sudden, excessive, rapid and local discharges of the nerve cells in the grey matter

47
Q

What is status epilepticus?

A

Uncontrolled series of seizures with no regain of consciousness in between attacks

48
Q

What are some causes of epilepsy in neonates? (5)

A
  • Birth trauma
  • Intracranial haemorrhage
  • Hypoxia
  • Hypoglycaemia
  • Hypocalcaemia
49
Q

What are some causes of epilepsy in children? (2)

A
  • Congenital abnormalities

- Metabolic storage disease (Phenylketonuria)

50
Q

What are some causes of epilepsy in young adults? (2)

A
  • Head injuries

- Drugs and alcohol

51
Q

What precautions should be taken during dental treatment of a patient with epilepsy? (3)

A
  • Use strong mouth props
  • Keep mouth as free as possible from debris
  • Ensure minimal equipment around patient area
52
Q

What are some dental relevant side-effects of the anticonvulsant Phenytoin? (2)

A
  • Gingival hypertrophy

- Folic acid deficiency

53
Q

What are some dental relevant side-effects of the anticonvulsant Sodium valproate? (2)

A
  • Thrombocytopenia (low platelets)

- Inhibits platelet aggregation

54
Q

If a patient has just had a seizure and is in the flaccid phase what should you do?

A
  • Place in recovery position and suction to remove secretions blocking airways
  • Administer oxygen (15L/min)
  • Administer midazolam
55
Q

What is Bell’s palsy?

Bilateral or Unilateral?

A

Acute paralysis of CN VII near stylomastoid foramen

usually unilateral

56
Q

What is the aetiology of Bell’s palsy?

A

Inflammation

of the facial nerves at stylomastoid canal

57
Q

What are some clinical features of Bell’s palsy? (3)

A
  • Pain around jaw/ear
  • Unilateral facial paralysis
  • Hyperacusis (noise sensitivity)
58
Q

What is Trigeminal neuralgia?

A

Characterised by brief electric-shock, lighting-like (lancinating) pain limited to the distribution of one or more divisions

BDS 2: CHHD (28 decks)

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