Diseases Of Nerves And Muscles Essay Question And Answers

Diseases Of Nerves And Muscles Important Notes

1. Disease and involved nerve

Diseases Of Nerves And Muscles Disease And Involved Nerve

2. Disease and affected areas

Diseases Of Nerves And Muscles Disease And Affects Areas

3. Causes of burning mouth syndrome

Diseases Of Nerves And Muscles Causes Of Burning Mouth Syndrome

4. Features of Eagle’s Syndrome

  • Elongation of the styloid process
  • Ossification of the stylohyoid ligament
  • Dysphagia
  • Sore throat
  • Otalgia
  • Glossodynia
  • Headache
  • Vague orofacial pain
  • Pain along the distribution of internal and external carotid artery

5. Horner’s syndrome is characterized by

  • Miosis – contraction of pupil
  • Ptosis – drooping of the eyelid
  • Anhidrosis and vasodilatation over face

Diseases Of Nerves And Muscles Short Question And Answers

Question 1. Mention the different types of neuralgias. Explain in detail about trigeminal neuralgia
Answer:

Types of Neuralgias:

  • Trigeminal neuralgia
  • Paratrigeminal neuralgia
  • Atypical neuralgia
  • Geniculate neuralgia
  • Glossopharyngeal neuralgia
  • Migrainous neuralgia
  • Occipital neuralgia
  • Postherpetic facial neuralgia
  • Sphenopalatine ganglion neuralgia
  • Superior laryngeal neuralgia
  • Tympanic plexus neuralgia

Trigeminal Neuralgia: It refers to the pain along the distribution of any branch of the trigeminal nerve

Trigeminal Neuralgia Etiology:

  • Idiopathic
  • Traumatic compression of the nerve
  • Biochemical change in the nerve cells
  • Abnormal blood vessels

Read And Learn More: Oral Pathology Question And Answers

Trigeminal Neuralgia Clinical Features:

  • Commonly effects older adults
  • Females are more commonly effected
  • Causes severe, unilateral, and lancinating types of pain
  • Pain lasts for only few seconds or minutes and then disappears
  • Pain occurs on stimulation of trigger zones
  • Trigger zones are:
    • Vermillion border of lips
    • Around eyes
    • Ala of nose
  • Stimulation of these zones occurs by
    • Shaving
    • Washing face
    • Applying lotion, cosmetics
    • Chewing
    • Brushing
    • Touching
    • Strong breeze
  • Pain produces spasmodic contractions of facial muscles
  • So this is called Tic doulorreux
  • Leads to poor lifestyle

Trigeminal Neuralgia Treatment:

  • Peripheral neurectomy
  • Injection of alcohol or boiling water into gasserian ganglion
  • Injection of steroid or anaesthetic agent into ganglion
  • Electrocoagulation
  • Administration of carbamazep pine and phenytoin
  • Microsurgical decompression of the trigeminal root

Trigeminal Neuralgia Differential Diagnosis:

  • Migraine
  • Sinusitis
  • Tumours of the nasopharynx
  • Trotter’s syndrome
  • Postherpetic neuralgia
  • TMJ disorder
  • Intracranial hemorrhage
  • Acute pulpitis

Question 2. Bell’s palsy
Answer:

Bell’s palsy

Idiopathic paralysis of the facial nerve of sudden onset

Bell’s palsy Etiology: 5 Hypothesis:

  • Rheumatic
  • Cold
  • Ischaemia
  • Immunological
  • Viral

Bell’s Palsy Clinical Features:

  • Pain in post auricular region
  • Sudden onset
  • Unilateral loss of function
  • Loss of facial expression
  • Absence of wrinkles on forehead
  • Inability to close the eye- an effort to do so causes rolling of the eyeball upwards
  • Watering of eye
  • Inability to blow the cheek
  • Nasolabial fold disappears
  • Tip of nose deviates
  • Loss of taste sensation
  • Hyperacusis
  • Slurring of speech

Bell’s Palsy Management:

  • Physiotherapy
  • Facial exercises
  • Massaging
  • Electrical stimulation
  • Protection to eye
  • Covering of eye with a bandage
    • Medical management
      • Prednisolone 60-80 mg per day
      • 3 tablets for 1st 4 days
      • 2 tablets for 2nd 4 days
      • 1 tablets for 3rd 4 days
    • Surgical treatment
      • Nerve decompression
      • Nerve grafting

Question 3. Myasthenia gravis
Answer:

Myasthenia gravis

Myasthenia gravis: It is an acquired autoimmune disorder characterised clinically by the weakness of skeletal muscles and fatigability on exertion

Myasthenia gravis Etiology:

  • Idiopathic
  • Autoimmune- antibodies are produced against acetylcholine receptors of the muscles

Myasthenia gravis Clinical Features:

  • Mainly involves middle-aged women
  • Weakness of voluntary muscles
  • Muscles of mastication and facial expression are involved
  • Difficulty in mastication and deglutition
  • Dropping of jaw
  • Slow and slurred speech
  • Taste alteration
  • Diplopia and ptosis
  • Weakness of neck muscles
  • Loss of weight
  • Dry mouth
  • Atypical facial pain
  • Candidiasis
  • Hyperplasia of thyroid gland
  • Death due to respiratory failure

Myasthenia gravis Treatment: Intramuscular administration of physostigmine

Question 4. Sphenopalatine neuralgia
Answer:

Sphenopalatine neuralgia

It is a pain syndrome referable to nasal ganglion

Sphenopalatine neuralgia Etiology:

  • Irritation of nasal ganglion
  • Irritation to vidian nerve

Sphenopalatine neuralgia Clinical Features:

  • Males below 40 years of age are commonly affected
  • Unilateral intense pain in the region of eyes, maxilla, ear, and mastoid, the base of the nose, beneath the zygoma
  • Pain is rapid in onset
  • Persists for 15 minutes to several hours
  • Absence of trigger zones
  • Pain occurs at exactly at same time every day so it is called alarm clock headache
  • Sneezing
  • Swelling of nasal mucosa
  • Severe nasal discharge
  • Epiphora
  • Watering of eyes
  • Paraesthesia of skin over lower half of face
  • Sphenopalatine neuralgia Treatment:
  • Alcohol injection into sphenopalatine ganglion
  • Use of ergotamine or methysergide
  • Surgical correction of septal defects

Question 5. Eagle’s syndrome
Answer:

Eagle’s Synonym: DISH syndrome

Eagle’s Syndrome Types:

  1. Classic type- occurs after tonsillectomy
  2. Carotid artery syndrome- Results from calcification of stylohyoid ligament
  3. Traumatic Eagle’s syndrome- develops after a fracture of the stylohyoid ligament

Eagle’s Syndrome Clinical Features:

  • Age- common in adults
  • Elongated styloid process
  • Pain In the lateral pterygoid area and side of the lower face and neck
  • Difficulty In swallowing
  • Sore throat
  • Glossodynia
  • Headache
  • Dull lo severe hemiacial pain
  • Blurred vision
  • Vertigo

Eagle’s Syndrome Radiographic Features:

  • Elongation of styloid process is seen
  • Eagle’s Syndrome Management:
  • Topical anaesthesia
  • Surgical resection or segmentation of elongated styloid process
  • Corticosteroid injection

Question 6. Frey’s syndrome
Answer:

Frey’s syndrome

This is auriculotemporal nerve syndrome

Frey’s syndrome Causes: Iatrogenic causes followed by parotidectomy

Frey’s syndrome Features:

  • Pain in auriculotemporal nerve distribution
  • Gustatory sweating
  • Flushing on affected side
  • Frey’s syndrome Diagnosis:
  • Positive starch iodine test

Frey’s syndrome Treatment:

  • Topical application of anticholinergic
  • Radiation therapy
  • Surgical procedures
  • Skin excision
  • Nerve section
  • Tympanic neurectomy

Question 7. Myofunctional pain dysfunction syndrome
Answer:

Myofunctional pain dysfunction syndrome

  • It is disorder characterised by facial pain limited to mandibular function, muscle tenderness, joint sounds, absence of significant organic and pathologic changes in TMJ
  • It may be due to functional derangement of dental articulation, psychological state of mind or physiological state of joint

Myofunctional pain dysfunction syndrome Etiology:

  1. Extrinsic factors
    • Occlusal dishormony
    • Trauma
    • Environmental factors
    • Habits
  2. Intrinsic factors
    • Internal derangement of TMJ
    • Anterior locking of disc
    • Trauma

Myofunctional pain dysfunction syndrome Clinical Features:

  • Unilateral preauricular pain
  • Dull constant
  • Muscle tenderness
  • Clicking noise
  • Altered jaw function
  • Absence of radiographic changes
  • Absence of tenderness in external auditory meatus

Myofunctional pain dysfunction syndrome Management:

  • Reassurance
  • Soft diet
  • Occlusal correction
  • Isometric exercises
  • Heat application
  • Diathermy
  • Anaesthetic injections
  • Steroids
  • Drugs
  • Aspirin- 0.3-0.6 gm/4 hourly
  • Pentazocine- 50 mg- 2-3 times a day
  • Diazepam- 2-5 mg for 10 days
  • Acupuncture

Question 8. Trigeminal neuralgia (or) Tie douloureux (or) Fotherglll’s disease
Answer:

Trigeminal neuralgia Synonyms:

  • Tic douloureux
  • Trifacial neuralgia
  • Fotherglll’s disease

Trigeminal neuralgia Clinical Features:

  • Commonly effects older adults
  • Females are more commonly effected
  • Causes severe, unilateral and lancinating type of pain
  • Pain lasts for only few seconds or minutes and then disappears
  • Pain occurs on stimulation of trigger zones
  • Trigger zones are:
    • Vermillion border of lips
    • Around eyes
    • Ala of nose
  • Stimulation of these zones occurs by
    • Shaving
    • Washing face
    • Applying lotion, cosmetics
    • Chewing
    • Brushing
    • Touching
    • Strong breeze
  • Pain produces spasmodic contractions of facial muscles
  • So this is called Tic doulorreux
  • Leads to poor life style

Question 9. Trigger zones
Answer:

Trigger zones

  • Trigger zones are cutaneous zones located along the distribution of division of nerve
  • These are:
    • Vermillion border of lips
    • Around eyes
    • Ala of nose
  • Stimulation of these zones occurs by
    • Shaving
    • Washing face
    • Applying lotion, cosmetics
    • Chewing
    • Brushing
    • Touching
    • Strong breeze

Trigger zones Results:

  • Pain
  • Poor life style

Question 10. Glossopharyngeal neuralgia
Answer:

Glossopharyngeal neuralgia

It refers to the pain occurring through the distribution of glossopharyngeal nerve

Glossopharyngeal neuralgia Etiology:

  • Abnormal blood vessels pressing on glossopharyngeal nerve
  • Growth at the base of the skull
  • Tumour or infection in the mouth

Glossopharyngeal neuralgia Clinical Features:

  • Pain occurs unilaterally on stimulation of trigger zones
  • Pain occurs in the ear, pharynx, tonsillar area and posterior part of tongue
  • Pain lasts for few seconds to few minutes

Glossopharyngeal neuralgia Trigger Zones:

  • Posterior oropharynx
  • Tonsillar fossa

Glossopharyngeal neuralgia Triggering Factors:

  • Chewing
  • Coughing
  • Talking
  • Swallowing
  • Laughing

Question 11. Facial causalgia (or) Atypical facial pain
Answer:

Facial causalgia

It constitute a group of condition in which there is a vague, deep, poorly localized pain in the regions supplied by 5th and 9th cranial nerves and 2nd and 3rd cervical nerves

Facial causalgia Causes:

  • Injury to any peripheral or proximal branch of trigeminal nerve
  • Facial trauma
  • Nasal skull fracture
  • Following extraction of multi-rooted teeth

Facial causalgia Treatment: Use of tricyclic antidepressants

Question 12. Gustatory sweating
Answer:

Gustatory sweating

  • It is sweating occurring on the forehead, face, scalnd neck soon after ingesting food
  • Occurs as a result of nerve damage as in Frey’s syndrome

 

Diseases Of Nerves And Muscles Viva Voce

  1. Glossodynia – painful tongue
  2. Glossopyrosis – burning tongue
  3. Neuritis is inflammation of nerve
  4. Causalgia is used to describe severe pain arising after injury or sectioning of peripheral sensory nerve
  5. Atypical facial pain lacks a trigger zone
  6. Atypical odontalgia is pain localized only to teeth
  7. Multiple sclerosis is idiopathic inflammatory de- myelinating disease of CNS
  8. Myotonia is failure of muscle relaxation over face after cessation of voluntary contraction
  9. Myasthenia gravis is acquired autoimmune diorder characterized by weakness of skeletal muscle and fatigability of striated muscle on exertion
  10. Myositis is inflammation of muscle tissue

 

 

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