Neurology- APEA
OBJECTIVE ASSESMENT EXAM
LATEST
WAVE<A+GRADED>UPDATED
SYLLABUS 100% GUARANTEED
PASS
Bell's Palsy:
Description - ANSWER ✅Disruption of facial nerve (cranial nerve VII) that
results in interruption of messages to brain.
Bell's Palsy:
Etiology (5) - ANSWER ✅1. Edema, inflammation or compression of CN 7
(facial)
2. Idiopathic
3. Viral Illnesses (Reactivation of the HSV)
4. Cold climates
5. Facial Trauma
Bell's Palsy:
RF (9) - ANSWER ✅-Lyme disease*
-Third trimester of pregnancy
-Family history
-Headaches
-Chronic middle ear infection
-High blood pressure
-Diabetes
-Sarcoidosis
-Tumors
Bell's Palsy: SX (lots) - ANSWER ✅- Symptoms begin suddenly*
- Unilateral facial paralysis *
,- Unable to wrinkle forehead**
- Numbness/Tingling
- Loss of nasolabial fold
- Drooping of eyelid*
- Drooping of conner of mouth*
- Drooling
- Dryness (mouth/eye)*
- Excessive tearing/inadequate tearing
- Ipsilateral loss of taste*
- Ringing in one or both ears
- Impaired speech
Difficulty eating or drinking
Bell's Palsy: DX - ANSWER ✅- Clinical presentation
- Lyme titer?
- CT r/o cva
Bell's Palsy:
NonRX
RX (2) - ANSWER ✅- Eye drops*, close and cover affected eye at night, warm
moist heat, massage
1. Oral steroids
*Mainstay!Improves outcomes
*Must start within 3 days of onset
* Tapered Prednisone PO x 10 days >16y
2. Oral Antivirals
* Acyclovir, famciclovir, valacyclovir
* Use w/ oral steroids! start w/in 72 hrs
Bell's Palsy:
Prognosis (4) - ANSWER ✅- Recovery times vary
- SX improve w/in 2 weeks
- Complete recovery typical in 4-6 months
- In rare cases, permanently impaired facial function
Trigeminal Neuralgia:
Description
, Etiology - ANSWER ✅- A severe, sharp, unilateral stabbing pain in the
distribution of one or more branches of the 5th cranial nerve (trigeminal nerve)
- Compression of the 5th cranial nerve from structural abnormality or idiopathic
cause
Trigeminal Neuralgia:
RF (5) - ANSWER ✅- Women
- Age 50-60
- Multiple sclerosis
- CVA
- HTN
Trigeminal Neuralgia: SX - ANSWER ✅- Shock-like, severe unilateral facial
pain
- Abrupt onset
- Pain is episodic w/ spontaneous remissions
- Pain triggers: eating, talking, brushing teeth, light touch
Trigeminal Neuralgia:DX - ANSWER ✅A. At least three attacks of unilateral
facial pain fulfilling criteria B and C
B. Occurring in one or more divisions of the trigeminal nerve, with no radiation
beyond the trigeminal distribution
C. Pain has at least three of the following four characteristics:
- Recurring in paroxysmal attacks lasting from a fraction of 1 second to 2 minutes
- Severe intensity
- Electric, shock-like, shooting, stabbing or sharp in quality
- Precipitated by innocuous stimuli to the affected side of the face
D. No clinically evident neurological deficit
E. Not better accounted for by another ICHD-3 diagnosis
Trigeminal Neuralgia:
RX (1) - ANSWER ✅1. Carbamazepine is recommended first-line therapy; 70-
98% of patients initially respond
*check carbamazepine levels & LFTs and CBC
OBJECTIVE ASSESMENT EXAM
LATEST
WAVE<A+GRADED>UPDATED
SYLLABUS 100% GUARANTEED
PASS
Bell's Palsy:
Description - ANSWER ✅Disruption of facial nerve (cranial nerve VII) that
results in interruption of messages to brain.
Bell's Palsy:
Etiology (5) - ANSWER ✅1. Edema, inflammation or compression of CN 7
(facial)
2. Idiopathic
3. Viral Illnesses (Reactivation of the HSV)
4. Cold climates
5. Facial Trauma
Bell's Palsy:
RF (9) - ANSWER ✅-Lyme disease*
-Third trimester of pregnancy
-Family history
-Headaches
-Chronic middle ear infection
-High blood pressure
-Diabetes
-Sarcoidosis
-Tumors
Bell's Palsy: SX (lots) - ANSWER ✅- Symptoms begin suddenly*
- Unilateral facial paralysis *
,- Unable to wrinkle forehead**
- Numbness/Tingling
- Loss of nasolabial fold
- Drooping of eyelid*
- Drooping of conner of mouth*
- Drooling
- Dryness (mouth/eye)*
- Excessive tearing/inadequate tearing
- Ipsilateral loss of taste*
- Ringing in one or both ears
- Impaired speech
Difficulty eating or drinking
Bell's Palsy: DX - ANSWER ✅- Clinical presentation
- Lyme titer?
- CT r/o cva
Bell's Palsy:
NonRX
RX (2) - ANSWER ✅- Eye drops*, close and cover affected eye at night, warm
moist heat, massage
1. Oral steroids
*Mainstay!Improves outcomes
*Must start within 3 days of onset
* Tapered Prednisone PO x 10 days >16y
2. Oral Antivirals
* Acyclovir, famciclovir, valacyclovir
* Use w/ oral steroids! start w/in 72 hrs
Bell's Palsy:
Prognosis (4) - ANSWER ✅- Recovery times vary
- SX improve w/in 2 weeks
- Complete recovery typical in 4-6 months
- In rare cases, permanently impaired facial function
Trigeminal Neuralgia:
Description
, Etiology - ANSWER ✅- A severe, sharp, unilateral stabbing pain in the
distribution of one or more branches of the 5th cranial nerve (trigeminal nerve)
- Compression of the 5th cranial nerve from structural abnormality or idiopathic
cause
Trigeminal Neuralgia:
RF (5) - ANSWER ✅- Women
- Age 50-60
- Multiple sclerosis
- CVA
- HTN
Trigeminal Neuralgia: SX - ANSWER ✅- Shock-like, severe unilateral facial
pain
- Abrupt onset
- Pain is episodic w/ spontaneous remissions
- Pain triggers: eating, talking, brushing teeth, light touch
Trigeminal Neuralgia:DX - ANSWER ✅A. At least three attacks of unilateral
facial pain fulfilling criteria B and C
B. Occurring in one or more divisions of the trigeminal nerve, with no radiation
beyond the trigeminal distribution
C. Pain has at least three of the following four characteristics:
- Recurring in paroxysmal attacks lasting from a fraction of 1 second to 2 minutes
- Severe intensity
- Electric, shock-like, shooting, stabbing or sharp in quality
- Precipitated by innocuous stimuli to the affected side of the face
D. No clinically evident neurological deficit
E. Not better accounted for by another ICHD-3 diagnosis
Trigeminal Neuralgia:
RX (1) - ANSWER ✅1. Carbamazepine is recommended first-line therapy; 70-
98% of patients initially respond
*check carbamazepine levels & LFTs and CBC
