Neurological: Radiculopathy, Neuropathy. Neuralgias.
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| Refers to dysfunction of a nerve root usually due to compression. | Radiculopathy
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| Name some signs and symptoms of radiculopathy. | Pain, paresthesias, weakness, diminished reflexes, other neurologic deficits
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| True or False: Location of symptoms of radiculopathy can help determine the etiology. | True
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| What is injury to sensory and or motor axons, myelin sheaths, and or neurons? | Neuropathy
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| 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
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| What are some symptoms of neuropathy? | 1. numbness
2. tingling
3. burning
4. pain
5. crawling sensaton
6. pricking sensation
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| 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.
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| Name some diagnostic considerations for neuropathy. | Electrodiagnostic studies: Nerve conduction study (NCS), and electromyography (EMG)
Labs: Vit B12, TSH, CBC, Sed Rate, HIV
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| Name some differential diagnoses. | 1. Diabetes
2. Vitamin B12 deficiency
3. Alcohol
4. Malignancy
5. Chemotherapy history
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| 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
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| What is acute paroxysmal pain radiating along the course of one or more nerves without demonstrating changes in the nerve structure. | Neuralgias
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| There are many types of neuralgia. Name some more common conditions associated with neuralgias. | 1. Trigeminal Neuralgia
2. post herpetic neuralgia
3. occipital neuralgia
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| 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.
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| 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
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| Differential diagnoses for trigeminal neuralgia include: | Multiple Sclerosis
TMJ
Pain secondary to disease of dental, sinus, or orbital origin
cluster headaches
atypical facial neuralgia
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| Name some treatment options for T.N. | MRI of the brain (to rule out tumor or diagnose MS)
Medication: tegretol, dilantin, neurontin
Surgical intervention
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| What is post-herpetic neuralgia? | Persistent pain along the nerve distribution affected by shingles. May be severe & linger for months
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| Treatment options for postherpetic neuralgia includes? | Medications: Lyrica, tricyclic antidepressants, topical agents.
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| Describe occipital neuralgia. | sharp shooting pain along the occipital nerve distribution.
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| Name a treatment for occipital neuralgia. | No diagnostic considerations - MRI if indicated.
treatment: nerve block, pain meds, can be self-limiting over some time
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