Bells Palsy + Trigeminal Neuralgia

Question 1

what are 2 causes of peripheral neuropathy?

Answer 1

side effect of medication
systemic disease

Question 2

a generalized process affecting many peripheral nerves, with the distal nerves usually affected most prominently

Answer 2

polyneuropathy

Question 3

any disorder of the peripheral nervous system

Answer 3

peripheral neuropathy

Question 4

refers to disorders of the central and peripheral nervous system

Answer 4

neuropathy

Question 5

pathology affecting an individual peripheral nerve

Answer 5

mononeuropathy

Question 6

what is the most common cause of mononeuropathy?

Answer 6

compression of the nerve

Question 7

acute peripheral facial nerve palsy

Answer 7

bells palsy

Question 8

what is the most common cause of bells palsy?

Answer 8

viral inflammatory/immune reaction

Question 9

what is the onset of bells palsy?

Answer 9

sudden (usually over hours)

Question 10

how do you differentiate between bells palsy and stroke?

Answer 10

eyebrow sag in bells palsy

Question 11

a patient presents with unilateral facial paralysis, eyebrow sagging, inability to close the eye, and disappearance of the nasolabial fold. Dx? and treatment? (3)

Answer 11

bells palsy

prednisone
OTC artificial tears
night eye ointment/protective glasses

Question 12

when does bells palsy reach maximal clinical weakness/paralysis?

Answer 12

within 3 weeks from the first day of visible weakness

Question 13

when does bells palsy reach recovery or some degree of function?

Answer 13

within 6 months

Question 14

what diagnostic can be used for bells palsy to determine prognosis?

Answer 14

EMG

Question 15

what treatment can be added for severe bells palsy?

Answer 15

valacyclovir

Question 16

which cranial nerve is involved with trigeminal neuralgia? which 2 branches?

Answer 16

CN V (5)
maxillary (v2) + mandibular branch (v3)

Question 17

what is the most common etiology of trigeminal neuralgia?

Answer 17

compression of trigeminal nerve root by artery or vein

Question 18

what causes the symptoms of trigeminal neuralgia?

Answer 18

compression, leading to circumscribed area of demyelination

Question 19

a patient presents with brief episodes of severe, stabbing focal pain unilaterally in the distribution of the affect branch. Dx? Treatment? (2)

Answer 19

trigeminal neuralgia

carbamazepine/oxcarbazepine
baclofen/lamotrigine

Question 20

what is trigeminal neuralgia triggered by? (3)

Answer 20

touch
movement
eating

Question 21

what secondary causes should be ruled out if a patient presents with trigeminal neuralgia? (3)

Answer 21

structural brain lesion
multiple sclerosis
vascular cause

Question 22

what diagnostic can be used for trigeminal neuralgia to rule out secondary causes? (2)

Answer 22

MRI/MRA

Question 23

what are other interventions for trigeminal neuralgia for patients who are non-responsive to meds?

Answer 23

microvascular surgical decompression
radiofrequency rhizotomy
gamma knife radiosurgery

Question 24

what treatment can be used for elderly patients with trigeminal neuralgia who are non-responsive to meds?

Answer 24

radiofrequency rhizotomy