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77 Cards in this Set
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- Back
- 3rd side (hint)
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What is the most common demyelinating disease
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Multiple Sclerosis
- 250 - 300k in US |
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T-cell mediated automimmune injury to myelin sheath and/ or oligodendroglial cells
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Multiple Sclerosis
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What are the 3 primary diseases of Myelin?
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1) Multiple Sclerosis
2) Acute disseminated encephalomyelitis 3) Leukodystrophies |
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-Wernicke-Korsakoff's syndrome
- paralysis of extraocular muscles - ataxia --->coma ---> death caused by? |
Thiamine Deficiency
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-motor/sensory spinal tract degeneration
-loss of proprioception and confusion caused by? |
B12 deficiency
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arsenic, mercury & lead are examples of what?
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neurotoxic metals
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alkaloids, isonaizid, metronindazole, methotrexate are examples of what?
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neurotoxic drugs
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most common form of dementia in the elderly
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Alzheimer's Disease
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what is the onset and predisposition to Alzheimer's Disease
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>50 yo
10% w/in family history |
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What are the etiological characteristics of Alzheimer's disease (3)?
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1) deposition of beta amyloid in senile plaques and cerebral vessels
2)hyperphosphorylation of Tau protein 3) Expression of alleles for apoprotein E |
BeTA
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what are the genetic factors related to Alz. D.?
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- Down's Syndrome
- Chromosome 21 - Chromosome 14 mutation |
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what presents with these clinicals:
Progressive impairment of memory and cognitive functions Progression over 5-15 years Disorientation and loss of language Development of parkinsonism Death from pneumonia |
Alzheimer's disease
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clinically presents with a disturbance of the dopaminergic pathways connecting the substantia nigra to the basal ganglia
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Parkinsonism
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Disturbance in motor function
rigidity slowing of voluntary movement expressionless faces stooped posture & tremor represents symptoms of what? |
Parkinsonism
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what are the causes of Parkinsonism?
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trauma
toxic agents vascular disease encephalitis idiopathic |
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paralysis agitans = ?
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idiopathic parkinsonism
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Degeneration of dopamine secreting neurons of the substantia nigra and locus ceruleus
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Parkinson's Disease
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What is the onset of Parkinson's disease?
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60 yo +
insidious onset over 10 year expanse |
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- affects chromosome 4 A^d
- increase in Huntingtin protein - progressive fatal disorder involving extrapyramidal motor system with chorea |
Huntington's Disease
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what disease may lead to suicide after the age of 30 to 40 yo?
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Huntington's Disease
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What is the name of Lou Gehrig's disease?
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Amyotrophic Lateral Sclerosis
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What percentage of ALS is sporadic?
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90%
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- Insidious weakness, clumsiness, speech difficulties, fasciculation (contractions)
- Progressive muscle weakness, atrophy & spasticity; death from respiratory failure or intercurrent infection within 5 years |
ALS
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mycoplasma infection, or allergic reaction following surgery (GA)
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Guillan - Barre' Syndrome
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Rapid, progressive segmental demyelination of peripheral motor nerves
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Guillan - Barre' Syndrome
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What would be a cause of death from Guillan - Barre' Syndrome?
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failure of respiratory muscles
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self limiting unilateral facial paralysis
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Bell's Palsy
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-acute otitis media
-atm pressure change -exposure to cold -nerve ischemia near stylomastoid foramen -local/systemic infxn -Melkerson-Rosenthal syndrome -Multiple Sclerosis -Pregnancy/eclampsia(seizures) are examples of? |
triggers for Bell's Palsy
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What is the gender discrepancy of Bell's Palsy?
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Females > (71%)
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A sudden onset of a rigid mask-like appearance with the inability to smile or wink, accompanied by xeropthalmia, slurred speech and drooling at corner of mouth is likely a case of?
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Bells Palsy
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Although treated with ______, _______, vasodilators, hyperbaric oxygen, nerve decompression, Bells Palsy can regress spontaneously in _______ and fully recovery by 6 months for ____ of the cases
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histamine
steroids 1-2 months 86% |
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Also called 'tic douloureux'
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Trigeminal Neuralgia
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characterized by severe, shock-like, lancinating pain in face = ?
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Trigeminal Neuralgia
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Considering Trigeminal Neuralgia is usually unilateral, what side of the face is most commonly affected?
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Right
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What gender is more so affected with Trigeminal N.?
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females
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What is a key diagnostic factor for Trigeminal N.?
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the pain (usually lasting < 2min) is limited to the branches of the CN V
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What are the trigger areas of the face in Trigeminal N.? (4)
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nasolabial fold
lip vermilion midfacial/periorbital skin intraorally (occasionally) |
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What are typically the most effective drug treatments for Trigeminal Neuralgia?
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Anti-convulsants:
carbamazepine = Tegretol gabapentin = Neurontin @ low gradual doses |
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Surgical procedure eradicating the pain from Trigeminal Neuralgia has been ____% successful
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70-85%
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paroxysmal pain in might suggest?:
-ear -infra-auricular area -tonsil base of tongue -posterior mandible (pt. points here) -lateral pharyngeal wall |
Glossopharyngeal Neuralgia (CNIX)
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What may trigger pain in CN9 Neuralgia?
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-talking
-chewing -swallowing -yawning -touching of tonsil |
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A disorder that may be mistaken for Temporomandibular disease (TMJ disorder)?
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GN
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what other than anticonvulsants and decompression surgery of CN9 may temporarily treat GN?
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topical anesthetic to affected tonsil/pharynx
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facial neuralgia with persistent pain in the maxillofacial region that does not fit the diagnostic criteria for other orofacial pains =?
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Atypical Facial Pain
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A 40 year old patient that is neurotic in the form of OCD and is a hypochondriac with persistent facial pain may be?
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Atypical Facial Pain
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'travelling patient'
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pain on the face in the form of:
-deep, gnawing ache -intense burning -pressure or sharp pain on small part of face -single alveolus or quadrant -temple -neck or occipital area |
Atypical Facial Pain
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What drugs besides anticonvulsants are used to treat Atypical Facial Pain?
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Tricyclics
SSRIs |
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A controversial entity said to be similar to ischemic bone necrosis known to occur in other bones; especially hips and knees
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NICO (Neuralgia Inducing Cavitational Osteonecrosis)
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With a 1/11,000 prevalence what gender is most affected by NICO?
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Females (35-60yo)
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If a patient describes their pain as:
-ill-defined -deep ache -sharp bone pain that increases in frequency, duration and intensity one ought to think of? |
NICO
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-decortication and curretage
-ax are tx for ? |
NICO
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What disease was involved in an 'Unconventional Dentistry' case group that was a result of dentists claiming to be experts in diagnosing and treating _____
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NICO
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Sphenopalatine Neuralgia or Horton's Syndrome?
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Cluster Headache
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Unilateral pain occuring in mid face and periorbital leading to tooth and jaw pain
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Cluster Headache
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80% of Cluster Headache pts. have this related factor?
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smokers
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What is the demographics of Cluster Headache?
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Males (6:1) aged 20-30yo
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lancinating pain occuring 'like an alarm clock' up to 8 times a day with :
-nasal stuffiness -facial flushing -conjuctival redness may be symptoms of what? |
Cluster Headache
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Prednisone
Lithium Indomethacin Ergotamine Methysergide....are all drugs for tx? |
Horner's Syndrome (cluster headache)
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Common disabling paroxysmal unilateral headache thought to be caused by vaso-constriction or spasm of cerebral artery, decreased Serotonin levels -- leading to pain and edema after vasodilation?
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Migraine
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What is the demograph of migraines
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Females
20-40 yo |
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Can be accompanied by an aura?
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migraine
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frontal, temporal, orbital pain accompanied by:
-nausea/vomiting -diarrhea -photophobia -phonophobia |
migraine
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multifocal vasculitis of cranial arteries (especially temporal aa.)
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Temporal Arteritis
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Unilateral throbbing headache (coinciding with heartbeat) that is gradually replaced by temporal / facial pain occuring more commonly in Whites over 50 yo
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Temporal Arteritis
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-pain during chewing, mimicking toothaches or jaw and tongue pain that may lead to perm.or transient vision 50% of the time?
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Temporal Arteritis
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Temporal Arteritis one may visualize _____ in the vessel wall under a microscope?
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Giant Cells
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Dyesthesia, pyrosis or dynia of the oral mucosa in the absence of mucosal alteration of 2-3% of adults
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Burning Mouth Syndrome
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What is the demograph of Burning Mouth Syndrome?
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Females (4-7:1)
PM women (3-12 yrs after) 14% |
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The spontaneous burning of the anterior dorsum of the tongue later in the day with diminished taste and exacerbated by hot foods/liquids?
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Burning Mouth Syndrome
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What are common behaviours of one with Burning Mouth Syndrome suggesting what success in drug prescription?
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Anxiety
Depression Irritability Mood altering: Librium 2/3 effective |
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persistent abnormal taste
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Dysgeusia
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diminished taste perception
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Hypogeusia
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lack of taste perception
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Aguesia
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what can lead to dysgeusia or hypoguesia?
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-systemic disorder
-post-radiotherapy -trauma -tumors -nerve inflammation -drugs (200+) |
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Auriculotemporal syndrome or gustatory sweating and flushing resulting from nerve injury (2-24 months post-surgery or infection)
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Frey Syndrome
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What % of Frey Syndrome pts. resolve
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5%
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possible tx for Frey Syndrome include:
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atropine
botox scopolamine cream severing nerve |
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