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Painful Conditions

Neurological: Radiculopathy, Neuropathy. Neuralgias.

QuestionAnswer
Refers to dysfunction of a nerve root usually due to compression. Radiculopathy
Name some signs and symptoms of radiculopathy. Pain, paresthesias, weakness, diminished reflexes, other neurologic deficits
True or False: Location of symptoms of radiculopathy can help determine the etiology. True
What is injury to sensory and or motor axons, myelin sheaths, and or neurons? Neuropathy
True or False: There are several types of peripheral nerves and they may be damaged by more than 10 different diseases and toxins. False. This number is 100 different diseases and toxins. It is neither one symptom or one disease. Example: diabetic, peripheral
What are some symptoms of neuropathy? 1. numbness 2. tingling 3. burning 4. pain 5. crawling sensaton 6. pricking sensation
Name some clinical findings of neuropathy. 1. look for atrophy 2. DTR's may be decreased or absent 3. Sensory Exam (stocking/glove distribution)touch, vibration, temperature.
Name some diagnostic considerations for neuropathy. Electrodiagnostic studies: Nerve conduction study (NCS), and electromyography (EMG) Labs: Vit B12, TSH, CBC, Sed Rate, HIV
Name some differential diagnoses. 1. Diabetes 2. Vitamin B12 deficiency 3. Alcohol 4. Malignancy 5. Chemotherapy history
Neuropathy treatments include: (DEPENDS ON THE CAUSE IF DETERMINED) Lyrica, Neurontin, Cymbalta Tricyclic antidepressants - amytriptyline or nortriptyline NSAIDS, opioids and other pain medications may be of benefit for difficult cases
What is acute paroxysmal pain radiating along the course of one or more nerves without demonstrating changes in the nerve structure. Neuralgias
There are many types of neuralgia. Name some more common conditions associated with neuralgias. 1. Trigeminal Neuralgia 2. post herpetic neuralgia 3. occipital neuralgia
What are common s/s of trigeminal neuralgia? Intense stabbing, shock-like pain along the distribution of the trigeminal nerve Pain is triggered by certain activities many times and is usually unilateral Majority of pts are women and >50 y/o.
Name some clinical findings of trigeminal neuralgia. Most often, exam of the sensory & motor componenty of the 5th cranial nerve is normal in idiopathic TN. Association of the cranial nerve abnormalities suggests other pathology
Differential diagnoses for trigeminal neuralgia include: Multiple Sclerosis TMJ Pain secondary to disease of dental, sinus, or orbital origin cluster headaches atypical facial neuralgia
Name some treatment options for T.N. MRI of the brain (to rule out tumor or diagnose MS) Medication: tegretol, dilantin, neurontin Surgical intervention
What is post-herpetic neuralgia? Persistent pain along the nerve distribution affected by shingles. May be severe & linger for months
Treatment options for postherpetic neuralgia includes? Medications: Lyrica, tricyclic antidepressants, topical agents.
Describe occipital neuralgia. sharp shooting pain along the occipital nerve distribution.
Name a treatment for occipital neuralgia. No diagnostic considerations - MRI if indicated. treatment: nerve block, pain meds, can be self-limiting over some time
Created by: MissyGirl3971