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pom-neuro disorders Flashcards

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1
Q

seizures- do they mean epilepsy? what else?

A

stress, sleep deprivation, drug/alcohol withdrawal, syncope

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2
Q

2 types of seizures?

A

partial (focal, local), generalized (convulsive or non-convulsive)

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3
Q

3 types of partial seisures

A

simple partial, complex partial, partial sizuresevolving to secondarili generalized seizures

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4
Q

5 types of generalized seizures

A

absence (petit mal), myoclonic, tonic clonic (grand mal), tonic, atonic

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5
Q

most common infection in kid?

A

acute otitis media

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6
Q

who is most likely to get seizure?

A

kid- due to fever (otitis media)

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7
Q

who else is likely to get seizures

A

elderly

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8
Q

why do old people get seizures

A

cerebrovascular dz

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9
Q

causes of seizurs- 6

A

head trauma, intracranial neoplasm, meningitis/encephalitis, metabolic disturbances, drug effects, ideopathic/epilepsy

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10
Q

does type of brain lesion determine what type of seizure you’ll have?

A

no

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11
Q

pathophysiology of seizure

A

excessive focal neuronal discharge that may spread to areas throughout the brain

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12
Q

first stage of gm seizure

A

aura

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13
Q

second stage of gm seizure

A

epileptic cry (air through diahram)

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14
Q

describe tonic phase of gm seizure

A

muslce rigidity, pupil dilation, eye movment, lose congiousness

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15
Q

describe clonic phase of gm seizure

A

uncoordinated movment

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16
Q

describe post-ictal phase (post neuronal firing ) of gm seizure

A

headache, confusion, sleepy

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17
Q

status epilepticus

A

emergency- seizure doesnt stop

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18
Q

describe absence seizure

A

seconds of lost conciousness, facial twitch, daydreaming, eyes flutter

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19
Q

ied-

A

interictal epileptiform discharges- neurologist looks for on eeg

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20
Q

tests to do on pt with seizure

A

diag, hx, blood test (cbc, electroylytes, glucose), eeg, ct, mri

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21
Q

draw what seizure looks like on eeg

A

ied- bigger squiggles than normal

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22
Q

who should take drugs for seizure

A

high risk pt? not sure who that would be

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23
Q

after how long of not having a seizure can you come off the drugs

A

2 yr

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24
Q

classic drugs for seizures

A

carbamazepin, phenytoin, valproic acid, phenobarbital

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25
recent drugs for seizures
gabapentin, lamotrigine, oxcarbazepin, topirimate
26
valproic acid side effect?
bone marrow supression
27
what percent of pt are resistant to drugs?
20
28
what should we do for pt who are resistant to drug
surgery or vagus nerve stimultion (increases seizure threshold)
29
how do we do dental tx on pt with seizures?
gotta do v. thorough hx- lab eval if needed (if on phenobarb do lab bc narrow TI
30
if pt is on VNS (vagal nerve stimulator) what should you avoid?
diathermy or any other device that heats up-
31
should you use a mouth prop on a seizure pt?
only if you have a retrieval method
32
what could we use if pt is having seizure to stop it?
diazepam iv or im
33
drugs that cause gingival hypertropy?
rinses: chlorohexidine rinse, folic acid, dilantin
34
what other oral issue is related to seizures
dry mouth, candida
35
what is ms
demylination of neurons in cns, an most common autoimmune dz of nervous system
36
age for ms?
age 20-40
37
men or women get more ms?
women 3/2
38
what infectious agents can cause ms?
trigger by infectious agent (rabies, mumps, measles, clap, hsv1,2, ebv, hhv-6
39
what else can cause ms other than infections ?
geneic factors (20-49x greater chance child getting it if parent has), geographical factors- countries further from equiator get it worse
40
what cant the nerves do in ms
impulse cant travel down ason, no saltatory conductin
41
affected areas in ms are called
plaques
42
what are plaques made of
macs, b+t cells, plasma cells, cytokines, ig
43
most common demylinated regins
optic nerve, periventricular cerebral white, cervical spinal cord
44
uhthoff's sign
symptoms are more hnoticable when there is a rise in body temp, so do some exercisoes to inc body temp to test this
45
lab findings for ms
inc ig in csf, mylin basic protein in csf (from breakdown of mylin), and mri sos hypodense demyelinated regions
46
meds for pt w ms?
anti inflamms, interferon b, chemotherapeutics
47
drug for spasticity
baclofen, bdz
48
drug for bladder control
anticholinergic
49
drug for fatigue
stimulant
50
symptoms dentist sould note when examining v1,2 3 if involved in ms
facial pain, can mimic trigemical neuralgia, facial paralysis, oral symptoms like skipping words, myokymia (muscle fasciculations)
51
ms relapse- should we treat?
only for emergency
52
when to tx?
during remission
53
cerebral palsy definition
disorders in the develpment of movemnt and posture, causing activity limitation, that are attributed to non progressive disurbances that occured in developing fetal or infant brain
54
motor probs of cp can be accompanied by these other things
disturbance in sensation, cognition, communicaiton, perception, behavior, and seizures
55
cuases of cp
anoxia, ischemia during labor, trauma, congenital infections, rubella, cmv, hsv, syphilis, influenza
56
spastic cp
70-80 percent of cases- inc muscle tone, results from upper motor neuron damage
57
types of spastic cp
diplegia, hemipleigia (one side of body) quadriplegia
58
oral problems seen in cp pt
malocc, injury, bruxism, sialorrhea, speach and swallowing difficulty, oral hygiene, venue for tx
59
parkinsons definition
dopamine deficiency causes degenerative cns disorder
60
primary parkinsons
degen of dopa neurons in substantia nigra
61
secondary parkinsons
loss or interference w action of dopaimine
62
factors cuasing parkinsons maybe
genetic mut, stroke, brain tumor, head injury, exporue to chemicals
63
signs of parkinsons-
resting rhythmic tumors, pill rolling, pain, bladder probsl, mood problems, dementia
64
meds for parkinsons
sinemet (carbidopa and levodopa)
65
glossodynia
burning mouth syndrome
66
oral issues in pt with parkinsons
oral and motor and sensory impariment, dysphagia, xero, candida, burning mouth suynrome
67
things to help parkinsons pt with oral health
electric brush, chlorohexidine rinse, topical fluoride, sialogogues (for xero)
68
alzheimers dz
neruodegenerative disorder characerized by dementia, gradual decline in cognitive processes, may lead to toal mental and physical disability
69
primary pathophysio of alz
beta amyloid depositon, neuritisplaques, neurofibrillary tangles
70
stage 1 alzheimers
memory loss, time disorientation, judgement erros, decline in appearance or hygiene
71
3 stages of alz progress over
8-10 yr
72
stage II alz
intellectual decline, cant recognize self, understand speech or recognize familar objects or people
73
stage 3 alz
terminal- disoriented, wasting, seizure, hyperorality, aggressive
74
death in alz is from?
malnutrition, infection, heart dz
75
drugs for alz
acetylcholinesterase inhibitors- tacrine, donepezil, rivastigmine, galantamine
76
what otc can help with alz
gingo biloba, nsaid, antioxidant
77
memantine
know- nmda receptor antagonist
78
nmda receptor antagonist action-
regulates glutamate activity, healp with learning and memory
79
if you put a restoration in a pt that has alz and it is high twhat can happen
it can trigger a behavioral change
80
myashthemia gravis
AI dz unknown cause
81
what happens in mg
autoab combine with ach at neuromusclar jxn, prevent transmission of nerve impulse
82
more men or women in mg?
women, but men more in the 60s and 70s yrs old
83
what abnomrality do mg pt frequently have?
thymic
84
what happens in itital phase of myasthenia gravis?
ptosis, diplopia, inability to blink continually
85
myasthenia crisis
resp involvment, in 20% of pt, 8% fatal
86
diag of mg?
serum level of ach receptor ab
87
tx of mg
acetylcholinesterase inhibitors
88
4 main tx modality in mg
anticholinesterase, thymectomy (dec quanity of ach receptor ab), ummunosupp therapy (high dose coritcostreoid), short term immunotherapy (plasmaphersis, iv ig)
89
dental considerations for mg
cranial nerve exam, faial and masticatory weakness, probs with prostethics, do short morning appt when they are stronger, can can't give muscle relaxants or anxiolytics to help bc ineract with mg

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