Pain Syndromes Flashcards
(33 cards)
centralized pain, widespread accompanied by fatigue, seep, memory or mood changes
nocioplastic pain
caused by irritation of the annulus, disc infection, herniation
discogenic pain
irritation of a nerve root due to a herniated nucleus pulposus or degenerative neuroforaminal narrowing.
radicular pain usually at L4-L5, L5-S1, C5-C6, C6-C7
How does radiculopathy affect LMN?
change sensation, weakness, decreased reflex
What causes spinal stenosis?
calcified ligamentum flavum or herniation. Distinguish with an MRI
What are surgical treatments of spinal stenosis?
Laminectomy or foraminotomy. If laminectomy and take out 3 or more laminas then the do the fusion.
What worsens/betters neurogenic claudication?
Worsened with:increased abdominal pressure,extension – Prolonged standing or walking,
Better with : flexion(“shopping cart” sign), - increases the anteroposterior diameter of thecentral canal.
When to order LP wuth headache?
neck pain, stiffness and fever
describes a wave neuronal depolarization in the cortical gray matter followed by neuronal activity suppression, resulting in blood flow changes
Cortical spreading depression MOA
Plexus of fibers from trigeminal ganglion in the right cerebral arteries, venous sinuses and dural matter resulting in painful neurotransmitter release
Neurovascular theory
Intracranial vasoconstriction results of ischemia and then causes the aura prior to migraines.
vascular theory
prevent migraines with …
BB, antiepileptic, TCA, gabapentinoids, Ca blockers
and more aerobics
ssociated with stress/anxiety/depression/poor posture
Pericranial tenderness induced by palpation is a hallmark feature of TTH
Tension headache
Cluster headache 9usually smokers and insane painwith lacrimation, sweating), paroxysmal hemicrania, short-lasting unilateral neuralgiform headache attacks, and hemicrania continua
Trigeminal autonomic cephalalgias
Treatment for cluster headache
intranasal lidocaine, O2
compression of TGN in artery, possible demyelination, reentry amplification
trigeminal neuralgia
treatment for TGN neuralgia
carbamazepine
A vascular HA caused by granulomatous inflammation of large and medium-sized cranial vessels that originate directly from the temporal artery
Giant cell arteritis
Why do you need to quickly diagnose giant cell arteritis?
prevent blindness secondary to anterior ischemic optic neuritis
What happens in centralizied sensitization that causes neuropathic pain?
inhibitoryinterneuronsnormallyareexcited byperipheralinput,attenuation of thisinput willdecreaseinhibition andamplify the painsignal.
compression or stretch injury affecting the myelin sheath without damaging the nerve. Conduction is intact both proximal and distal to, but delayed the site of injury.Leads to temporary sensorimotor deficits distal to that site that resolve over time
neurapraxia
focal demyelination and axonal damageleading towalleriandegeneration.Axonalregeneration andreinnervation are required for recovery,which may occur spontaneously or require surgery.
axonotmesis
complete transection of all neural structures, including the axon and itsconnective tissue. Without intact connective tissue elements, there canbe no organized regeneration and surgical intervention is required
neurotmesis
What are symptoms of carpal tunnel?
paresthesias, dysesthesias, with tingling in the “m” fingers