Abscess (peritonsillar, dental), Epistaxis, Facial Nerve Disorders (bells palsy, trigeminal neuralgia),

Question 1

also known as tic douloureaux, causes a sudden, usually unilateral severe brief, stabbing, recurrent pain in the distribution of one or more branches off the 5th cranial nerve

unilateral facial pain precipitated by chewing, brushing the teeth or putting on makeup

may cause facial spasm (tic)

tx - adjuvant analgesics (carbamazepine, phenytoin, oxcarbazepine, clonazepam, lamotrigine, valproic acid, gabapentin)

Answer 1

trigeminal neuralgia

Question 2

paralysis to one side of the face (rarely both sides), often caused by herpes simplex virus

may take weeks to months to resolve, cannot close eye on affected side, inability to purse lips on affected side, ipsilateral loss of taste and hyperacusis

differentiate from stroke - causes paralysis of forehead (strokes usually spare the muscles of forehead), eye will roll back in the head when patient attempts to close eyelid (with strokes eye doesn’t move)

tx - steroids

Answer 2

bells palsy