Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Oral med > Chronic facial pain > Flashcards

Chronic facial pain Flashcards

(62 cards)

Start Studying
1
Q

What are the three dimensions of pain?

A

Sensory

Motivational

Cognitive

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does allodynia mean?

A

Pain due to a stimulus that does not normally provoke pain.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does hyperalgesia mean?

A

heightened pain from a stimulus that does usually produce pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is paresthesia?

A

An abnormal sensation, whether spontaneous or evoked.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is dysthesia?

A

an unpleasant abnormal sensation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is neuralgia?

A

A paroxysmal and often severe pain in the distribution of a sensory nerve or nerves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is neuropathic pain?

A

Pain caused by a lesion or disease of the somatosensory nervous system.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is neuropathy?

A

A disturbance of function or pathological change in a nerve: in one nerve, mononeuropathy; in several nerves, mononeuropathy multiplex; if diffuse and bilateral, polyneuropathy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the definition of chronic pain?

A

Longer than 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which sub group of people is chronic pain more commen in?

A

Pain with prominent psychosocial dysfunction:  Mood disorders. Affective disorders eg. Depression

 Anxiety disorders. Disorders in which a certain situation or place triggers excessive fear and/or anxiety symptoms eg. generalized anxiety disorders.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is somatization?

A

Somatization is the presentation of physical symptoms as a manifestation of psychological distress.

Symptoms are usually unexplained or

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What the main neuralgias of the head and neck which cause pain?

A

Trigeminal neuralgia

Post herpetic neuralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the primary headache syndroms,vascular disorders and cerebrospinal fluid syndromes that cause pain?

A

Classic Migraine (Migraine with Aura)

 Common Migraine (Migraine without

Aura)

 Migraine Variants

 Carotidynia

 Mixed Headache

 Cluster Headache

 Paroxysmal Hemicrania

 Temporal Arteritis (Giant Cell Arteritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What types of pain is associated with physchosocial cause?

A

Chronic pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is primary trigeminal neuralgia?

A

Sudden, severe, recurrent stabbing pains in the distribution of one or more branches of the Vth cranial nerve.

Always effects the primary afferant neurone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of pain is associated with trigeminal neuralgia?

A

Sharp, agonizing electric shock-like stabs or pain felt superficially in the skin or buccal mucosa.

usually there are triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the time pattern of trigeminal neuralgia?

A

Only for a couple of seconds but can happen every couple of mins for a period

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the site of the pain caused in trigeminal neuralgia?

A

Unilateral (95% of the time)

Path of 5th cranial nerve

Often only affects one of the 3 divisions but occasional two.

The most common divisions that it affects are Maxillary, then mandibular then opthalmic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the differential diagnosis of trigeminal nerualgia?

A

Secondary trigeminal neuralgia- tumour,anuerysm

Multiple sclerosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the treatment for trigeminal nerualgia?

A

 Carbamazepine

 Oxcarbazepine

 Gabapentin
 Lamotrigine

 Phenytoin

 Baclofen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the surgical treatment for trigmeminal neuralgia?

A

Glycerol nerve blocks

 Partial sensory

rhizotomy

 Radiofrequency ablation of the trigeminal ganglion

 Microvascular decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is glossopharyngeal neuralgia?

A

Paroxysmal bursts of sharp, lancinating pain felt in the distribution of CNIX, particularly the throat, tonsillar fossa and adjacent area of fauces.

Spontaneous or evoked, often by coughing or swallowing.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How can you treat glossopharyngeal neuralgia?

A

application of local anaesthetic to

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is this? what is the pain characterised by?

A

Post herpatic nerualgia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What type of pain does post herpatic nerualgia cause?
Constant pain of moderate intensity but the constant nature makes it intolerable and consquently depression can ensue.
26
How can you prevent primary herpatic neuralgia?
high-dose aciclovir during initial Herpes Zoster (shingles) episode.
27
How can you treat post herpatic neuralgia?
Amitriptyline, Pregabalin, topical lignocaine or capsaicin patches. Success rates of treatment are low.
28
What pain is associated with TMJDS?
Aching in the muscles of mastication, sometimes with an occasional brief severe pain on chewing, often associated with restricted jaw movement and clicking or popping sounds. unilateral dull and achy but can be constant
29
What are the signs of TMJDS?
Restricted mandibular opening with or without deviation of the jawto the affected side on opening Tenderness to palpation of the muscles of mastication Clicking or popping at the joint on auscultation or palpation  Changes in the ability to occlude the teeth fully.
30
What imaging can be used for patients with TMJDS?
plain film or MRI. On the plain film you may see degenerative changes. On an MRI you may see disk displacement
31
How do you manage TMJ disorders?
 Occlusal splints  Heat packs  TMJ exercises and massage Medications - NSAIDs (topical/systemic) - Anxiolytics, TCAs  Psychotherapy  Surgical options
32
What are the exacerabating factors of a tension headache
 Emotional stress  Anxiety and depression  Physical exercise  Alcohol (which may also have the opposite effect).
33
What is the managment of tension headaches?
 Relaxation techniques  Analgesics  Anxiolytics may help but should generally be avoided since some patients become depressed and others develop dependence.  Tricyclic antidepressants e.g. amitriptyline.
34
What is Atypical facial pain?
A chronic facial pain of unknown aetiology.
35
How to manage atypical facial pain?
 Reassurance  Topical measures:  Difflam, lignocaine and capsaicin patches  TCAs, other antidepressant meds  Gabapentin, pregabalin  Alternative therapies  Pain team involvement  Psychotherapies
36
What is atypical odontalgia?
Pain from a tooth with no associated pathology Throbbing pain, may be moderate to severe but constant Can change location from tooth to tooth.
37
What are the associated factors with atypical odontalgia?
TMJDS, oral dysaesthesia, and pains of psychological origin. Often excessive concern with oral hygiene.
38
How do you manage atypical odontalgia?
Same as atypical facial pain
39
What is oral dysthesia?
Unpleasant abnormal sensation of oral tissues. Burning Mouth Syndrome is a burning pain in the tongue or other oral mucous membranes. Most often tip and lateral surface of the tongue but can occur in all of the mucosal areas.
40
what are the associated symptoms with oral dysthesia? what investigations should be done?
 Dry mouth  Persistent dysgeusic taste, altered taste perception, thirst  Burning increased with tension, fatigue, speaking, and hot food, and decreased with sleeping  Denture intolerance **Bloods** – anaemia, haematinic deficiency, diabetes, CT disease **Swab** – candidal infection
41
How do you manage oral dysthesia?
 Correction of any underlying pathology  Topical rinses – Difflam, Zinc sulphate  Vitamin B Co-Strong  TCAs  Gabapentin, pregabalin  Alternative therapies  Psychotherapies
42
What are the three types of migraine?
Classic migraine  Common migraine  Complicated migraine
43
What are the symptoms of a classi migraine?
Attacks of throbbing head pain preceded by an aura. The aura is often visual disturbances Pain is typically unilateral, starting in the fronto-temporal unaltered by medications and can last upto 75 hours
44
What are the precipitating factos of a classic migraine? what are the signs and symptoms?
Stress, mood changes, relaxation, dietary causes (chocolate, alcohol, cheese, citrus fruits, etc.), flashing lights, atmospheric changes i.e. noise/smoke nausea, anorexia, photophobia
45
How to manage migraines?
 NSAIDS/Paracetamol  Anti-emetics  Ergot preparations  Prophylactic Beta-blocking agents i.e. propranolol or seretonin antagonists i.e. pizotifen  Serotonin 1D receptor agonists like sumatriptan
46
What is a cluster headache?
Excruciatingly severe attacks of unilateral headache, principally in the ocular, frontal and temporal areas, recurring in separate bouts with daily, or almost daily, attacks for weeks to months, usually with autonomic symptoms and signs on the symptomatic side. 80-90% male The pain is constant, stabbing, burning, or even throbbing. A cluster period usually occurs every 6-18 months
47
What are the associated signs and symtoms with cluster headaches
ipsilateral ptosis A reduction in heart rate Runny nose
48
How do you manage cluster headaches?
 Ergot preparations  Oxygen inhalation  Intranasal lignocaine  Corticosteroids, Verapamil, Lithium or Pizotifen prophylaxis  Serotonin 1D receptor agonists i.e. Sumatriptan (S/C)
49
What is temporal arteritis?
A vasculitis affecting branches of the External Carotid Artery with resulting obliteration of the vessel lumen and ischaemia of the part supplied. unilateral or bilateral Continuous aching or throbbing can be associated with polymyalgia rheumatica
50
Associated signs and symptoms with temporal arteritis?
The temporal artery on the symptomatic side may be pulseless, tender to palpation, bulging and irregular in its appearance. Involvement of the Cenral Retinal Artery can lead to reduced visual acuity - an “alarm” situation needed immediate therapy (corticosteroid therapy) to prevent permanent blindness. Chewing can become deficient towards the end of the meal, masticatory ischemia. can get gangrene
51
How do you manage and investigate temporal arteritis?
A temporal artery biopsy may reveal giant cell arteritis (unreliable)  Raised ESR. (erthyrocyte sedimentation rate) Treat-  Corticosteroids  Immunosuppressive therapy e.g. azathioprine therapy
52
Carbemazepine is a commom medication used for chronic facial pain. What dosage should be given?
Initially 100-200mg od- bd  **Max dose** 1.6g/24hrs  **Side-effects:**  N&V, Dizziness, Ataxia  Headache, confusion  Blood dyscrasias,hyponatraemia  Rash, Stevens-Johnson Syndrome, TEN  Hepatitis, Acute renal failure
53
what is the dosage and the side effects of oxcarbazepine?
## Footnote 300mg bd ** Max dose** 46mg/kg/24hrs **Side-effects**: **** Similar however usually better tolerated than Carbamazepine
54
what is the side effects and dosage of gabapentin?
Day 1: 300mg od Day 2: 300mg bd Day 3: 300mg tds **Max dose** 3.6g/24hrs **Side-effcts:**  D&N&V, abdo pain  Weight gain, HTN, Hyperlipidaemia  Dizziness, confusion, headaches, peripheral oedema
55
Dose and side effects of pregabalin?
 75mg bd ** Max dose** 600mg/24hrs **Side-effects**: As gabapentin however generally better tolerated.
56
Dose and side effects of lamotrigine?
**25mg od** **Max dose** 500mg daily **Side-effects:**  Rash, hypersensitivity  Stevens-Johnson Syndrome, TEN  Hepatic dysfuction  Blood dyscrasias
57
Dose and side effects of Baclofen?
5mg bd-tds **Max dose** 100mg/24hrs ** Side-effects:**  GI upset  Hypotension  Dry mouth  Drowsiness, sedation, dizziness, confusion, muscular hypotonia
58
what are the two types of antidepressants used for chronic facial pain?
Tricyclic antidepressant's or Selective serotonin reuptake inhibitors (SSRIs) ## Footnote
59
What are the types of TCA's, the dose and side effects?
 Amitriptyline  Nortriptyline  10mg on, increased to 70mg on as needed  Side-effects:  Sedation, dizziness, ataxia  Dry mouth, constipation, urinary retention, blurred vision  Cardiac arrhythmias
60
what are the main SSRI's, dose and side effects?
Citalopram 20mg od ** Max dose** 60mg/24hrs ** Side-effects**: - GI upset - Hypersensitivity - Generally well-tolerated and less sedating that the TCAs
61
What are the difficulties in managing chronic facial pain patients?
 Difficulties explaining non organic pathology  Fear of missing organic disease  Overwhelmed by pain behaviour exhibited by patient.  Managing co existent organic pathology
62
How cna you predict the patients which are not going to respond well to treatment?
Defensive patients Use of terms of endearment to report disease Excessive focus upon symptoms Overt and hostile criticism of previous treatment History of repeated episodes of inadequate treatment

Oral med (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions