Medical Marijuana Argumentative Analysis

Medical Marijuana Argumentative Analysis
This year, millions of Americans are weighing in on one of the most controversial and pressing
issues in our country today: medical marijuana. It's no secret that some states have already embraced
the ambiguous federal laws surrounding this topic. However, when examining the pros and cons of
medical marijuana it is important to distinguish fact from fiction.
First, in order to discuss the logistics of this situation it is imperative to understand what medical
marijuana actually is. Medical marijuana (medical cannabis) refers to the use of cannabis and
constituent cannabinoids such as THC (Tetrahydrocannabinol), as medical therapy to treat disease or
alleviate symptoms.
Most notably cannabis is used to reduce nausea and vomiting ... Show more content on
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Cannabidiol, one of the major components in marijuana, is thought to be the key to marijuana's
medical benefits.
The way cannabidiol works of the receptors of the brain is unclear. However, select studies show
potential to relieve convulsion, inflammation, cough, congestion and nausea, and to inhibit cancer
cell growth.
Even when put in the most objective of lights, the intricacies of the situation are highly complicated.
It is not only the USA that is having an issue with medical cannabis.
While legalized in Austria, Canada, Belgium, Finland, Israel, Netherlands, Spain, and the UK, the
United Nations policy is one that focuses on the promotion of general public welfare and the
specific needs of a region. Despite this, many of the world's countries still criminalize marijuana in
every form for all intents and purposes.
The debate is endless. There are a multitude of reference points on each side of the fence that back
up each argument. America could go on forever like this. However, 20 out of the 50 states (and DC)
have already adapted the use of medical marijuana. The most notable of those being California,
Colorado, and Washington; and Florida may be next on the
... Get more on HelpWriting.net ...

Trigeminal Neuralgia
Trigeminal neuralgia is one of the most unfortunate and psychologically devastating medical
conditions known to men. This chronic pain disorder is characterized by recurrent episodes of
lacinating pain in one side of the face – often around the jaw or teeth. Episode can last seconds,
minutes or even hours, and repeat several times per day. Patients generally describe the pain as an
electric shock, stabbing or burning sensation on the face. Trigeminal neuralgia is one of the most
painful conditions documented in medical literature, and victims frequently endure frustatingly long
struggles before the disease is correctly diagnosed. The disorder is also colloquially known as the
'suicide disease'. Current drug–based treatments (anticonvulsants, muscle relaxants or
antipsychotics) bring some relief to most patients, but at the price of potentially dangerous side
effects. A new drug developed by researchers at the University of Zurich promises a better
compromise for patients.
Selective inhibition of sodium channel 1.7
The new drug called BIIB074 underwent a phase 2 trial across multiple ... Show more content on
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The new drug blocks the sodium channel 1.7 according to the channel's level of activity – the more
active the channel is the stronger will be the drugs hampering effect. Current drugs, in comparison,
block the sodium channels without accounting for the activity level, which results in unecessary side
effects. Sodium channels are located in nerve cell membranes. Their activation triggers the sensation
of pain, the severity of which is proportional to the channels' activity level. According to the Zurich
researchers, trigeminal neuralgia is believed to stem from a nerve deficiency or damage at the base
of the skull. Given that local injections cannot reach this region, drugs are the first line of defense
against the

Gabapentin Case Study
Achieve satisfactory benefit in epilepsy through Gabapentin
How to Buy Gabapentin Pills Online, Buy Neurontin (Gabapentin) online, for antiepileptic
treatment purchase Gabapentin Online, Buy Gabapentin Online without prescription, get Gabapentin
coupon code
Gabapentin became a routine drug therapy for me because of manic disorder. I had panic attacks too.
When I consulted the doctor, he made the necessary investigations and explained me that the best
way to stay mentally calm and healthy is to take Gabapentin. I started taking 2700 mg per day in
three divided doses. It helped me in getting rid of the panic attacks. I could even sleep properly
because of this medicine. Gabapentin is responsible for increasing the gamma amino butyric acid
levels in the brain indirectly. It does not bind to plasma proteins and therefore remains unchanged. It
does not undergo any metabolism and is removed as it is, from the body in the form of urine. You
can take this medicine with or without food as food does not affect its absorption. Gabapentin is
available for purchase from online pharmacy stores for antiepileptic treatment. It is legal to buy
Gabapentin online even without prescription.
The indications of Gabapentin are as follows.
1. Hypnotic agent because of its sedative properties
2. Used in panic ... Show more content on Helpwriting.net ...
It has no noteworthy hepatic cytochrome P450 or pharmacodynamic interactions. Antacids that
contain Aluminium Hydroxide and Magnesium Hydroxide decrease the absorption of Gabapentin by
20 percent if they are taken simultaneously. If they are taken two hours before taking Gabapentin,
there is no effect on its absorption. Gabapentin can cause false positive result with the Ames N–
Multistix SG dipstick test that is done to check proteins in urine. When the patient is undergoing
renal dialysis or has kidney disorders, the drug should be used

Odontogenic Pain
Odontogenic pain
Pulpal disease
Reversible pulpitis produces a quick, sharp, pain response that subsides when the stimulus is
removed. Any irritation to the pulpal tissue may produce this response like caries, cracks, or broken
restorations. Teeth often react to heat and cold stimuli or sugar contact. Normally, the tooth is not
tender to percussion and radiographic evaluation does not show any radiographic changes. Removal
of the cause is essential to prevent the inflammation from spreading, and eventually leading to
irreversible pulpitis. Irreversible pulpitis: Pain associated with irreversible pulpitis is usually
spontaneous. Patients report waking up at night with moderate to severe pain. Electrical and thermal
pulp tests produce severe ... Show more content on Helpwriting.net ...
Symptoms are usually characterized by deep, dull pain with occasional exacerbations of sharp pain.
MFPS is characterized by having muscular trigger points especially affecting the muscles of
mastication that stimulate pain and can result in referred pain to teeth. Tenderness to palpation,
limited range of motion, and stiffness are all characteristics of MFPS. A patient can present to the
dental clinic with dull, aching pain in the maxillary anterior teeth as a manifestation of pain referred
from the most anterior part of the temporalis muscle. Pain from the masseter muscle can be referred
to the mandibular molars. When pain is referred from the posterior–superior part of the temporalis
muscle, dull pain can occur in the maxillary premolars and maxillary molars. Stimulation of a
trigger point in the digastric muscle will result in pain referred to the lower incisors and pain
referred from the sternocleidomastoid muscle can be felt in the ipsilateral canine (Yount K.,

Multiple Sclerosis Case Study
Pathophysiology
Multiple sclerosis is a disease where your immune system attacks the protective barrier around your
nerves, called myelin sheaths (Mayo Clinic Staff, 2014). Your immune system falsely recognizes
these sheaths as being intruders in the body causing it to attack them leading to nerve damage (this
is called an autoimmune disease). With this nerve damage, there is disruption of the signals being
sent from your brain and travelling to the rest of the body impairing movements, causing pain or
numbness and a variety of other symptoms. Over time, the actual nerves begin to lose function and
disintegrate (Mayo Clinic Staff, 2014).
Two other characteristics are involved in the disease process: inflammation and the formation of
lesions or plaques in the central nervous system – or CNS (Mayo Clinic Staff, 2014). Lesions are
formed when oligodendrocytes – myelin–building cells – are lost causing the myelin sheath to thin
or even completely breakdown leaving the nerve axon exposed and unable to send effective signals
to your muscles (Huether and McCance, 2008). The oligodendrocytes attempt to remyelinate the
axons but with multiple attacks, the ... Show more content on Helpwriting.net ...
What most clinicians say regarding "attacks" is that a patient may have them months or even years
apart (Medscape, 2014). A patient may complain of leg pain and several months later have visual
disturbances (Medscape, 2014). The most common symptoms seen in MS patients are as follows:
sensory loss, muscle cramping and spasms, bladder/bowel/sexual dysfunction, optic neuritis (loss of
vision, muscle movements impaired), tremor, trigeminal neuralgia (facial weakness, typically
bilateral), facial myokymia (twitching of facial muscles), eye symptoms, heat intolerance, fatigue,
dizziness, sleep disturbance, pain, cognitive impairments (concentration, memory, attention span
and judgment), depression, and seizures (Medscape,

Trigeminal Neuralgia Essay
INTRODUCTION
Trigeminal Neuralgia (TN) is a chronic, usually unilateral disorder, characterized by brief,
paroxysmal electric–shock like pain, abrupt in onset and termination and limited to the sensory
distribution of one or more branches of the trigeminal nerve. The aim of this retrospective study is to
analyze the demographic and clinical data of patients with TN who had received the treatment from
Jan 2004 to Jan 2015 at the Oral Medicine clinic, University Dental Hospital Peradeniya (DHP).
MATERIALS AND METHODS
Records of 104 patients with a minimum follow–up period of one year, diagnosed with TN were
reviewed retrospectively for patient demographics, the characteristic features of the pain and
efficiency, complications of different types ... Show more content on Helpwriting.net ...
The mandibular division of the trigeminal nerve has been the most frequently affected branch
(46.2%) followed by the maxillary division (41.5%) and rarely the ophthalmic division (3.8%).
The majority described their pain as an electric–shock like pain (70.2%) and that lasts for 1–2
minutes (58.7%). The most common triggers were chewing 21.7% and washing face 9.4%.Magnetic
resonance imaging (MRI) of the brain was done in 28.1% of patients and 72.4% of the reports
revealed the vascular impingement of the trigeminal nerve by the Superior Cerebellar artery. No
other intracranial lesions were reported in MRI scans.
Majority of the patients was managed with oral medications alone, whereas 29.8% were managed
with local anesthetic injection in addition to the conventional oral medication. 70.2% of patients had
improvement only with oral drugs. About 2.9% were received Botox injection when the
conventional oral medication and nerve blocks were failing to control the pain. 89.4% of patients
had a pain free interval and a majority (75.3%) had <3 months of pain free duration. A statistically
significant relationship was found between the site and the duration of the pain free interval
(p=0.001). Cold weather (27.4%) was frequently associated with the pain

Trichotillomania Research Paper
Despite being a lengthy word, Trichotillomania is simpler than it seems. According to White Kress,
Trichotillomania is simply "the recurrent desire to pull out one's hair" (White Kress, 185–190).
However, as simple as it seems, the real cause of what is frequently referred to as TTM, is unknown.
The symptoms and signs of it are easy to tell from the psychical signs, though they often will be
hidden as those who have it may deny that they exhibit the traits of it. As of now, there is not a
definite medicine to stop this disorder, however with the use of OCD medicine and therapy; patients
of TTM are getting help.
As previously mentioned, there is no absolute cause for why TTM comes about in patients. Often it
seems to start around the ages of twelve and thirteen, however it is not uncommon for it to start
earlier or later. It is usually associated with stressful events such as: abuse, family conflict, death of
a parent or moving (MHA). TTM is considered a mental disorder and for many people, it can be
related to obsessive–compulsive disorder (OCD) but it does not have to be. Other behaviors that
may be associated are nail biting, thumb sucking, compulsive scratching, compulsively picking at ...
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Behavioral therapy is often used as a way to help those with TTM, some even using group therapy
as a way to help patients feel unashamed by being around others who can relate. Therapy along with
OCD medicine is the most current treatment available. The OCD medicine is to help curb the urge
to pull whilst the therapy can help them stop. Prozac, Luvox and Paxil are some of the commonly
used medicines to treat patients (MHA). Along with this are somewhat controversial ways to stop
TTM like hypnotherapy. "Hypnotherapy has been effective in treating habit disorders, such as tics
and thumb sucking, as well as trichotillomania" (White Kress,

My Mother Was Diagnosed With Trigeminal Neuralgia
For the past couple of years, I have witnessed first hand the effects that trigeminal neuralgia does to
the human body. My mother was diagnosed with trigeminal neuralgia in 2010. She was suffering
from the pain of the condition for more than two years before she was correctly diagnosed at MD
Anderson in Houston, Texas. My mother always explained her pain as worse than childbirth, and
that is because she has had four children. It caused my mom to have multiple sleepless nights, an
aching jaws, constant and excruciating pain, and in one extreme incident, her job locked while she
was chewing causing her to choke and had to receive the Heimlich maneuver. Being that she said it
was the worst pain in her life, my family knew it was something more than chronic migraines:
which is what one of the doctors she saw in the Rio Grande Valley diagnosed her with. When my
mother was first diagnosed, she as well as us: her family had no idea what the trigeminal neuralgia
was or how it affected my mother. Being that trigeminal neuralgia was something relatively new in
the bioscience community, not many doctors knew how to treat TN. Trigeminal neuralgia was
speculated to have been known about since 150 AD when Aretaeus of Cappodocia, a Greek
physician, wrote about a condition almost identical to TN in one of his medical texts. Many
speculated that he was writing about chronic migraines, which is what my mother was diagnosed
with when she first started experiencing pain. Trigeminal

Nervous Systems And The Nervous System
The nervous system functions as the communication and control system of the body through
electrical and chemical signals. It responds to stimuli through gathering information, interpreting it,
and providing an appropriate response. The nervous system is responsible for our thoughts, actions,
and emotions (Marieb & Hoen, 2013). The nervous system is also responsible for involuntary
actions such as blinking (Mandal, 2010). It is made up of the brain, spinal cord, and nerves. The
nervous system can be separated into the Central Nervous System and the Peripheral Nervous
System. The CNS consists of the brain and spinal cord and is the control center that integrates
messages. The PNS consists of the cranial and spinal nerves and is what connects the rest of the
body to the CNS so that communication is possible. The PNS then separates into the Sensory
Division, which carries impulses from receptors to the CNS, and the Motor Division, which carries
impulses from the CNS to effectors. The Motor Division then separates further into the Somatic
Nervous System, which controls voluntary function such as skeletal muscles, and the Autonomic
Nervous System, which controls involuntary function such as the digestive tract and the beating of
the heart. The Autonomic Nervous System can be broken down even further to the Sympathetic
Division, which is the "fight or flight" response, and the Parasympathetic Division, which is the
"rest and digest" system (Marieb & Hoen, 2013).

Definition Essay On Being Strong
When people hear the word "strong" they may think of a long list of things such as steel, big
muscles, or even bonds. I on the other hand believe that "strong" is so much more than physical
strength or something's ability to withstand excessive stress. In my short 18–year life I have seen
and defined "strong" in my own way. To me, "strong" is a mental, emotional, and physical quality
possessed by those who have chosen to push forward when life pushes them back. When I Googled
the word "strong" I found that the first result states, "having the power to move heavy weights or
perform other physically demanding tasks." This is the most common idea of the word. Instead of
thinking of the 8–year–old with leukemia or the mother who has lost everything, people generally
think of Superman or a giant steel structure. I believe that people generally confuse having physical
strength for being strong. Having strength is having the ability to lift weights or do labor intensive
tasks; it is a purely physical characteristic. Being strong, however is making the decision to call
someone when ending it all seems to be the best option or keeping a ... Show more content on
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Whether it was my mother continuing her pregnancy when diagnosed with an inoperable brain
tumor or when I witnessed the extreme sadness in my great grandmother's eyes brought on by
ungrateful grandchildren. I have also experienced "strong" first hand, as I have health problems.
When I was in 9th grade I was diagnosed with gastroparesis or paralyzed stomach. I lost most of my
friends and missed weeks of school due to this; it caused me both physical and emotional pain. I
later was diagnosed with Trigeminal Neuralgia (chronic nerve pain) caused by a Chiari
Malformation 1(a brain/skull abnormality). It is the most excruciating pain I have ever endured. I
had to have physical strength to make it through both but being strong got me through the times
when physical strength wasn't good

Persistent Pain On The Dento Alveolar Region Of Unknown Cause
Persistent pain in the dento–alveolar region of unknown cause has been named in different ways in
the scientific literature. It is still worth mentioning "phantom tooth pain", a term coined by Marbach
et al. that has been abandoned in the last 15 years. Marbach considered this painful condition merely
as a deafferentation problem. His opinion was that whenever a tooth was denervated (not only
extracted), the brain cortex would reorganize and occasionally a phantom sensation expressed as
pain would remain (15). Defining PDAP merely as phantom pain comes from assumptions that are
not based on studies with evidence higher than level 5. The term "atypical odontalgia" (AO) has
been the most adopted until 2012 and it is still utilized from a vast portion of researchers and
clinicians. In 2004 atypical odontalgia was officially recognized by the International Headache
Society in the ICHDII (International Classification of Headache Disorders, 2nd Edition) as a
localized form of Persistent Idiopathic Facial pain (PIFP), included in the central causes of facial
pain (16). We can find two unsupported assumptions in this classification as well. First, in 2004,
when the ICHD II was released there was not enough data to support that atypical odontalgia was
caused by either central or peripheral mechanisms. Second, there is a single study that investigates
in a scientific fashion possible relations between atypical odontalgia and persistent idiopathic facial
pain and it is based only

Neuropathic Pain
When a patient reports a toothache, it is important that we do not jump to conclusions before
considering all the signs, symptoms, and history. There are many causes of pain, both odontogenic
and non–odontogenic that may mimic a "toothache." Making the wrong diagnosis can at the very
least be embarrassing, and in some cases may be tragic.
An important fundamental paper by Brannstrom and Astrom1 explored a possible mechanism to
explain dentinal pain and sensitivity. In an experiment where air was blown on exposed dentin, they
noticed a significant outflow of fluid from the dentinal tubules. They postulated that dentinal
sensitivity may be caused by the rapid flow of fluid in either an inward or outward direction at the
pulpo–dentinal border. ... Show more content on Helpwriting.net ...
Herpes zoster can mimic tooth pain and must be included in a differential diagnosis. Lopes et al.5
described a case report in which the signs and symptoms led to a diagnosis of pulpitis in the right
maxillary diagnosis. However, there was not enough evidence and no treatment was done. 4 days
later, the patient had multiple vesicles on the face, and a herpes zoster viral infection was diagnosed.
The patient was successfully treated with acyclovir.
10. Neuropathic pain is a broad category of non–odontogenic orofacial pain that should be in the
differential diagnosis. Trigeminal neuralgia is often described as sharp, shooting, and stabbing
pain.6 There is usually a trigger point which responds to light tactile, but not painful, stimuli. Pain is
not provoked by thermal stimulus and local anesthetic block of the trigeminal nerve is effective in
arresting the pain. Other neuralgias include glossopharyngeal and post–herpetic neuralgia.
11. Atypical Odontalgia is tooth related pain in an area where a tooth was extracted or where there
are no signs of pathology.7 There may be associated psychological disorders such as anxiety and
disorders. If pulp tests are vital and there is no sign of apical periodontitis, cracked tooth should be
ruled out. Occlusion should be checked. Then tests should be performed for central and peripheral
sensitization. If pain persists MRI of the brain should be performed and the appropriate referral
should be

The Ischemic Stroke
First I feel that, it is important to understand the clinical manifestation of the different strokes. The
Ischemic stroke can cause a wide range of neurologic symptoms depending on the location and the
size of the effective area. Patients may present with symptoms, such as, numbness or weakness of
the face, arms, legs, more so, one side of the body, changes in moody or behavior, trouble with
speaking or understanding speech, visual disturbances, having difficulty in walking, dizziness or
loss of balance and sudden server headaches. Hemorrhagic stroke has, also, presents with the same
clinical manifestation as a Ischemic stroke, however, most patients complain of server headache.
Next would be being having the understanding of the different

Herpes Zoster and the Complications of Post-Herpetic...
Many people can remember to a time when they were a little kid and tiny little red bumps began to
form on different locations of their skin. The small bumps began to spread and began to itch.
Remembering the pink color of the calamine lotion that was used to soothe the itching sensation,
realizing that these bumps were chicken pox. It is common knowledge that once a person contracts
chicken pox and the outbreak clears up, the person will not get an outbreak again. Yet there are
unknown complications that may develop later in life from having the chicken pox. Herpes zoster
(Zoster), or commonly known as Shingles, is one of these complications. Not only is this a very
painful condition, but can lead to other complications as well. ... Show more content on
Helpwriting.net ...
This entire process takes anywhere from a few days to a few weeks. Shingles often clear up on its
own without any medical assistance or topical creams. Treatments for outbreaks that do not clear up
on their own; often include cold compresses, oral anti–viral medications, and corticosteroid creams.
A person who has an outbreak of Shingles typically only has one to three outbreaks in their lifetime
(Mandell GL., et al, 2009). There have been, however, cases where the scabs disappear yet the pain
continues even after the rash is gone. In some cases, this pain associated with the herpes zoster virus
lasts for years. The continuous pain is called Post–herpetic neuralgia (Nordqvist, C., 2009).
Post–herpetic neuralgia is a severe pain along the route of a nerve. There have been five features
reported in case studies that is associated to the development of post–herpetic neuralgia. These
include age, severity of pain at rash onset, severity of pain, extension of rash at first occurrence,
female gender, and ophthalmic location (Coen, P., et al, 2006). This pain is a result to a change in
the neurological structure and function of that particular nerve. This pain is considered to be non–
nociceptive pain because it comes from within the nervous system itself. Nociceptive pain is the
type of pain a person would feel when they put their

Special Needs : Multiple Sclerosis
Special Needs: Multiple Sclerosis
Introduction
Multiple Sclerosis is a lifelong, incurable disease, which affects people in many different ways. It is
characterized as a chronic, progressive immune–mediated disease that varies in intensity from mild
to severely disabling. Some present with a condition that involves only one or two periods of
activity throughout their life. Others suffer major complications in a rapid progression of disease.
The word "multiple" accurately describes this condition, as it is unique to every individual. It is
important for all health care providers, including those in the dental profession, to understand the
general concept of Multiple Sclerosis, in order to provide the optimal care for their patients.
Etiology
The cause of Multiple Sclerosis is still unknown. A combination of factors may play a role in
causing this disease such as the immune system, environment, infectious diseases and genetics
(Stachowiak, 2014). MS is an "abnormal immune–mediated response that attacks the myelin coating
around nerve fibers in the central nervous system, as well as the nerve fibers themselves" (National
Multiple Sclerosis Society, 2014). Scientists are further investigating the immune–mediated process.
Environmental factors, such as vitamin D, play a role in MS. For instance, MS occurs more
frequently in those who live further away from the equator. "Infectious diseases, such as viruses, are
recognized as causes of demyelination and inflammation, a

The fifth cranial nerve out of 12 is known as the...
The fifth cranial nerve out of 12 is known as the trigeminal nerve. Cranial nerves are located in the
brain and each have a different function. The trigeminal nerve is located in between the oculomotor
nerve and the facial nerve. The trigeminal nerve performs sensor functions that involve the teeth,
tongue, nose, and eyes and is covered by a myelin sheath. A myelin sheath is the protective coating
that is usually found around nerves. Trigeminal neuralgia also known as TN, is a painful disease that
affects the trigeminal nerve. The disorder causes severe, sporadic, sudden burning or shock–like
face pain that can last as short as a few seconds to as long as two minutes per episode of pain.
Patients suffering from the disorder may sometimes ... Show more content on Helpwriting.net ...
Normal blood pressure is 120/80. A Magnetic Resonance Imaging test may also be performed to
check for any abnormalities in the patient's head. Sometimes doctors may notice that the right
carotid artery is larger than usual had a small "bubble" may be attached, which could be affecting
the Trigeminal nerve. Usually an aneurysm explains the "bubble" found in a patient's MRI results;
an aneurysm is a bulge in the artery. Aneurysms are very dangerous because if they rupture too
much blood will enter her brain. Another cause of TN may be too much pressure being applied on
the nerve from a blood vessel. Endovascular coiling will help prevent the aneurysm from causing
more damage. Doctors insert a small catheter into an artery through the groin area and thread it up to
the affected blood vessel in the brain. Then they insert small platinum wire coils into the catheter
and into the aneurysm. Once in the aneurysm, they conform to the shape of the sac and cause the
blood to clot, effectively sealing off the aneurysm and preventing leakage of blood into the brain. As
far as the sharp pains there are various medications that can be prescribed to relieve some of the
symptoms and to assist in lowering the rate of the attacks. After treating an aneurysm the patient
should begin to take better care of their health, this will include changing their diet in order to lower
their blood pressure if it is too high. Some patients may have to receive surgery in order to

Compare And Contrast The Discovery Of Phenytoin And Later...
The discovery of phenytoin and later trimethadione by using standard animal seizure models gave
impetus to thousands of candidate drugs for the treatment of seizures. Between 1945 and 1950,
several investigators conducted tests with a variety of seizures models, but failed to find one in
which all drugs were active. In 1953 carbamazepine was synthesized by Schindler at the Geigy
laboratories in Switzerland [26]. In 1960 a succinimide derivative ethosuximide was discovered for
the treatment of epilepsy. Initially in 1962, it was used to treat trigeminal neuralgia, and later in
1963, it was used clinically to treat epileptic seizures. Interestingly all antiepileptic drug
developments from 1912 to 1960 were based on a simple heterocyclic ring structure.

Occupational Therapy Research Paper
Afflicted by left–side Hemiplegia and bound to a wheelchair, my grandmother's life was not one of
ease. By the time I was born she had been living with her barriers for thirty years and had learned to
compensate due to her astounding will and surrounding subpar medical practices. As a child I
thought nothing of the fact that my grandmother was stricken with paralysis until I witnessed her
take a turn for the worse and suffer another hemorrhagic stroke. Her recovery was long and arduous
yet, it was a blessing that brought us closer together and nudged me down the path of Occupational
Therapy. During my grandmother's recovery she spent significant time in a nursing home facility. At
the nursing home there was a male occupational therapist ... Show more content on Helpwriting.net
...
Professionally, I've had the opportunity to hold four different jobs that all revolve around catering to
people. Through working at the grocery store, the landscaping business, the student services at my
University and by being a camp director for summer youth sports programs I have gained valuable
experience with people of all ages. Along with this, I had the opportunity to be a part of a mission
trip that went to New Orleans a few years after the tragedy of Hurricane Katrina. It was moving to
be able to help the citizens in need and see how strong willed they were after such a recent disaster.
Personally, I believe that even the things I do in my free time have aided me in my preparation for
the career of occupational therapy. Whenever I have open leisure time I am either running or playing
music in my band. Running has made me a good planner and someone who doesn't quit as training
for long runs such as marathons takes as much mental toughness as physical toughness. Also, being
a band member has required a lot of practice, planning and organization. I must practice to keep my
skills on par, stay organized and communicate effectively with my band mates to write songs and
hold practices. All of my experiences have aided me in my preparation for becoming an
occupational

Chicken Pox Epidemiology
This paper will give an overview of the varicella–zoster virus. This paper will also discuss the
detriments of health from the chickenpox virus. The epidemiologic triangle will be outlined as it
depicts the chickenpox virus. The aspect of the community health nurse will be discussed and
information on a national organization for infectious diseases will be provided.
Chicken pox and shingles are caused by the virus varicella–zoster. The varicella–zoster virus is
spread through the air by coughing or sneezing and can also be spread by touching the blisters or
inhaling particles from the blisters ("CDC," n.d.). Chicken pox (varicella) is a highly contagious
virus. The reactivation of the chickenpox virus (varicella–zoster virus) is ... Show more content on
Helpwriting.net ...
Receiving the appropriate vaccinations is important not just to the individual, but is important to the
community as well. An individual not receiving the appropriate vaccines can put the entire
community at risk. The detriments of health can reach further than common healthcare, partnering
with sectors of public health is important to improve the overall health of the community.
The epidemiological triangle has three vertices: "the microbe that causes the disease" (agent), "the
organism harboring the disease" (host), and the "external factors that allow the disease
transmissions" (environment) ("CDC," n.d.) If one of the sides of the triangle are broken, a
disruption occurs between the agent, host or environment halts the continuation of the disease.
Varicella–zoster only occurs in humans. Chickenpox occurs most commonly in children under the
age of fifteen and less commonly in adults ("CDC," n.d.).
The agent for this example of the epidemiological triangle is varicella–zoster. Viruses have core
genetic material and take over cells to reproduce that genetic material. Varicella–zoster is a virus
that is spread through airbourne droplets such as by coughing or sneezing, inhaling infected particles
from the blisters or by touching the blisters. Chickenpox is highly contagious. It can take ten to
twenty–one days for symptoms to appear. Infected individuals can be contagious for one to two days
prior to outbreak of

Pharmacological And Surgical Treatment Of Trigeminal...
Pharmacological & Surgical Treatment of Trigeminal Neuralgia
Trigeminal Neuralgia (TN) is painful facial syndrome that can be treated through various drugs and
surgical procedures. The syndrome has been defined by the International Association for the Study
of Pain (IASP) as "sudden, usually unilateral, severe, brief, stabbing, recurrent pains in the
distribution of one of more branches of the fifth cranial nerve" . The two primary disease types that
have been observed clinically are: idiopathic, which occurs spontaneously, and lesion form– which
is seen as a tumor, cyst, or multiple sclerosis. Epidemiological studies indicate that TN is a rare
disease; studies showed that "incidence in women and men based on U.S. data between the years
1945 and 1984 was 5.7 and 2.5 per 100,000per year, respectively and incidence rates increased with
age." . Despite these statistics misdiagnosis was relatively common among diseased individuals and
it is likely that some of these cases were in fact dental pain, sinusitis, and temporomandibular
disorders. Due to diagnostic discrepancies, newer studies discovered "overall incidence was 12.6%
per 100,000 person–years with a mean age of 51.5 years and a 66% female preponderance" as of
2009. Through the use of clinical evidence–based journals clinicians are able to understand more
clearly the diseases pathophysiology and treat patients with this painful syndrome. In the most
common type of TN, most patients experience "arterial compression of

Trigeminal Neuralgia Research Paper
Trigeminal neuralgia is a chronic pain condition that is caused by inflammation of the trigeminal
nerve. In patients with trigeminal neuralgia, even mild stimulation leads to intense pain. The pain
may be short isolated episodes, but it can progress to longer and more frequent bouts of intense pain.
This chronic pain condition causes extreme, sporadic sudden burning or shock–like face pain. The
intensity of pain can be physically and mentally incapacitating and debilitating to patients with
trigeminal neuralgia, although the disorder is not life–threatening. Pain episodes can occur every
few hours, minutes, or seconds and then disappear for months or years until next episodes. There is
always the risk that trigeminal neuralgia will recur without any signs of warning. ... Show more
content on Helpwriting.net ...
In the days before an episode begins, some patients experience a tingling or numbing sensation or a
somewhat constant and aching pain. There is usually a worsening of pain over time, with fewer and
shorter pain–free periods before the attacks occur again. Trigeminal neuralgia generally does not
occur when the patient is asleep, and this differentiates from tooth pain or migraines, which often
wakes them up at night. Pain is located in areas in the body that are supplied by the trigeminal
nerve, including the cheek, jaw, teeth, gums, lips, or less often the eye and forehead. Pain can either
focus in one spot or spread in a wider pattern. An acute onset of sharp, stabbing pain usually affects
one side of the face. The right side of the face five times more often affected than the left side of the
face. Pain generally begins at the angle of the jaw and radiates along the junction lines between each
of three branches of cranial nerve V. (CN

Symptoms And Treatment Of Non Odontogenic Toothache Essay
Non odontogenic toothache, as its name suggests, is a painful condition that occurs in the absence of
any clinically evident cause in the teeth or periodontal tissues.
In approximately 3.4% of the teeth that receive endodontic treatment, the pain is either initially
caused by a nonodontogenic etiology, or the posttreatment pain is due to a nonodontogenic
phenomenon, and 9% have a mixed condition of odontogenic and nonodontogenic toothache
If the reason for the pain cannot be identified at the exact location the patient perceives it,
investigate whether its etiology is in the region.
Nonodontogenic toothache may arise from a primary condition or from multifactorial aetiologies;
nonodontogenic toothache was categorised into eight groups according to primary disorders as
follows: 1) myofascial pain referred to tooth/teeth, 2) neuropathic toothache, 3) idiopathic
toothache, 4) neurovascular toothache, 5) sinus pain referred to tooth/teeth, 6) cardiac pain referred
to tooth/teeth, 7) psychogenic toothache or tooth ache of psychosocial origin and 8) toothache
caused by various other disorders.
Nonodontogenic toothache is a heterotopic pain. It consists of projected nerve pain which is felt
throughout the peripheral distribution of the affected nerve (trigeminal neuralgia, cluster headache,
post herpetic neuralgia etc.) or referred pain as a result of convergence and central sensitisation
(myofascial pain referred to tooth/teeth, toothache, sinus pain referred to
tooth/teeth,

Shingles in Older Adults
Shingles in Older Adults Kim Walton, RN Olivet Nazarene University GNS 312 Strategies for
Student Success BSN 190 NRSG 102 Cathi Schlosser December 14, 2013 Certification of
Authorship: I certify that I am the author of this paper and that any assistance I received in its
preparation is fully acknowledged and disclosed in the paper. I have also cited any sources from
which I used data, ideas, or words, either quoted directly or paraphrased. I also certify that this paper
was prepared by me specifically for the purpose of this assignment. Your Signature: Kim Walton,
RN________________________________ You are a nurse working in a physician's office. You are
rooming a 75–year–old woman that arrives today ... Show more content on Helpwriting.net ...
5). Finally, there is a vaccine that has been shown to reduce the number of cases of shingles in
patients over the age of 60 known as Zostavax. This is a one–time vaccine used to actually prevent
the disease. It is given subcutaneously in a patient's arm. It is important to educate the patient that
even though it is a proven immunization for fighting shingles, Medicare Part B (the patient's
medical coverage) does not cover the vaccine. The patient may have Part D coverage (prescription
coverage) that will cover the vaccine, however, it must be given at a pharmacy, not a physician's
office or clinic setting. This is confusing for the patient, causing some of them to forego the vaccine
altogether. Some patients believe that once they have had the shingles they do not need to get the
vaccine. However, this is untrue. As this is a virus that stays within the body even after an outbreak,
the best way of preventing further outbreaks is with the immunization. If a patient presents with
active skin lesions, the vaccine literature advises waiting until resolution of these lesions prior to
receiving the vaccine. As our children have an immunization schedule, it is now becoming practice
that our aging adults also have an immunization schedule. This schedule now includes pneumovax
(pneumonia vaccine), influenza vaccine, TDaP (tetanus, diphtheria and pertussis)

Loma Carrie Case Study
Recently we had an Alumni professor come and speak at colloquium, he went by the name Monte.
When he attended Pacific Union College, he was a teaching in the social work and psychology
department. He spoke about the living in Angwin for 18 years before moving to Loma Linda to
teach in the master's program. His main goal of the presentation was to show the students and staff
the new research he was working on in Loma Linda. He is it was the 74,973 dollar question. What a
precise amount, however, this example was shown to bring light in the problems of Medicare.
Before Monte started his teaching career, he was studying in the state of Utah working with
programs for the elderly. Working for elderly programs involved a lot of research and managing. ...
We did not have the option to guess, only to know. By the end of the survey, it was shown that no
one knew anything about the contracts that an insurance company provides. After that survey, he
then gave us the same survey with a paper of the contract at hand this time a few were able to
understand and know what the contract said. nonetheless, still only have the class did not understand
and they had the copy of the contract, he wanted to make a point that contracts aren't always so
helpful and can actually confuse a person more. This made me realize that many agencies are not
always truthful or helpful when showing you the contract. It is important to take action and do
something about it. That is why Monte, is teaching in the research aspect of Social work, changing
the way people think and sooner or later make a policy in the

Essay On Odontogenic Etiology
There are numerous conditions which could result in the pain experienced by a patient who reports a
"toothache". Many times, an odontogenic etiology–such as caries, cracked tooth, infection, or
periodontal abscess–for the pain can be identified, treated, and resolved. However, in some cases,
there is no odontogenic etiology for the pain, requiring a more complicated differential diagnosis.
After eliminating the possibility of odontogenic conditions by examination, radiography, and pulp
tests, several other conditions should be considered.
Fungal and viral infections can both cause orofacial pain. One common fungal infection of the
mouth is Candida albicans, whose symptoms typically include white patches or plaques on the
mucosa or tongue (SOURCE). Viral infections such as Herpes virus and Epstein–Barr virus ... Show
more content on Helpwriting.net ...
Trigeminal neuralgia is a chronic neuropathic pain conditions which typically causes numbness,
pain, and/or burning in the area around the trigeminal nerve (NINDS, 2013). In patients with
trigeminal neuralgia symptoms, careful questioning about any concurrent health issues or symptoms
may allow diagnosis of an underlying systemic causes, such as neoplasm or multiple sclerosis
(Dumas, 1999), which may require referral to an appropriate specialist. Fibromyalgia is another
neuropathic pain condition, which results in symptoms including chronic, widespread pain,
hyperalgesia, fatigue, and sleep problems; additionally, this condition has a high comorbidity rate
with irritable bowel syndrome, depression, and anxiety disorders (Jin, 2014). One condition that can
be misdiagnosed as fibromyalgia is myofascial pain. Myofascial pain and fibromyalgia both involve
trigger points; however, unlike the former, myofascial pain involves asymmetrical pain in a taut
muscle band. Myofascial pain may also be misdiagnosed as odontogenic pain, so it is important to
assess radiographic exams, trigger points, and symptoms

Trichinosis Research Paper
Trichinosis Trichinosis is a rare infection caused by a parasitic worm. People can become infected
by eating the raw or undercooked meat of an animal infected with this worm. Bear meat and pig
meat are possible sources of this infection. The severity of the illness will vary depending on the
number of worms in the contaminated meat that is eaten. Once the worms are eaten, they enter the
intestines and can cause symptoms. From there, the worms travel through blood vessels to other
areas of the body. When worms reach the muscles, a cyst forms around the worms. The illness can
range from mild to severe. In mild to moderate cases, most symptoms will go away in a few months.
The infection can cause serious health problems if the worms heavily

Cranial Nerve Essay
Cranial nerves are components of the peripheral nervous system; connecting directly to the brain.
The twelve pairs of cranial nerves are named relating to their distribution and function; the number
assigned to a cranial nerve corresponds to the nerve's position along the longitudinal axis of the
brain, beginning at the cerebrum. Each cranial nerve is classified by their primary function; as a
sensory nerve, motor nerve, or a mixed nerve – of which contains a combination of sensory and
motor nerves. The largest and most complex of the twelve paired cranial nerve, the trigeminal (CN
V) supplies sensations to the face, mucous membranes and various structures of the head. This nerve
is divided into three branches, exiting the skull through three separate foramina; the ophthalmic
nerve, maxillary nerve, and mandibular nerve. Together these branches innervate these areas of the
head and include both motor and sensory ... Show more content on Helpwriting.net ...
Located along the jaw line, the mandibular nerve innervates the lower third of the face; playing a
key role in sensation and motion of the lower jaw (mandible). Other areas include the lower lip,
lower teeth and gums, chin, and the pre auricular and temporal areas. Additionally, it relays the
sensations involving touch/position and pain/temperature of the mouth. Trigeminal Neurolgia (TN)
is a form of neuropathic pain; a condition that affects the trigeminal nerve, specifically, the
mandibular division, causing sharp, stabbing, or burning unilateral pain in the cheek and jaw areas.
TN is characterized as "short, intense attacks, that increase in length and severity." (Auvenshine &
Pettit, 2015) Often patients report these attacks to be accompanied by a brief facial spasm or tic. In
response to the pain, patients often grimace, wince, or make aversive head movements; hence this
condition is also known as "tic douloureux." (Singh,

Trigeminal Neuralgia Essay
Trigeminal neuralgia, or tic douloureux, is a well–recognized disorder that most commonly occurs
in people over 50 years of age and slightly more commonly in women than in men.( Scrivani et al.,
2005) Trigeminal neuralgia is characterized by paroxysms of unilateral facial pain, most commonly
in the second and third trigeminal divisions, that are severe and lancinating.
Low–intensity mechanical stimulation of the trigger zones by speaking, washing or eating can
provoke pain.(Love and Coakham, 2001) The condition is usually treated with carbamazepine or
other anticonvulsant medications, although surgical management has also been used in recalcitrant
cases. Diagnosis of trigeminal neuralgia is based primarily on a history of characteristic pain attacks
that are consistent with specific, widely accepted research and clinical criteria. For most patients ...
This type of trigeminal neuralgia is called "classical trigeminal neuralgia" and its cause is unknown,
although vascular compression of the trigeminal nerve roots is often suggested. In a smaller group,
the signs and symptoms of trigeminal neuralgia are secondary to those of another disease process
that affects the trigeminal system, such as multiple sclerosis or a cerebellopontine–angle tumor. This
type of trigeminal neuralgia is called "symptomatic trigeminal neuralgia. Patients with orofacial pain
complained from the xerostomia and they expressed a decrease in salivary flow rate.( Scrivani et al.,
2005). Siviero et al reported non–significant differences in the saliva flow in between idiopathic
trigeminal neuralgia and trigeminal postherpetic neuralgia. Literature review revealed that there is
no published data on the oral health–related QoL using the 14–item Short Form Oral Health Impact
Profile (OHIP–14) in patients with

Carbamazepine Speech For Diabetes
"On average geniuses weren't qualitatively better in their fields than their peers. They simply
produced a greater volume of work, which gave them more variation and a higher chance of
originality."
By–Adam Grant
So, just what is carbamazepine and why would you need to know about it?
I have said several times here on Niume, that I am no Hemmingway and that holds true, I'm also,
most assuredly NOT a doctor but I am a type II diabetic, an amputee in a wheelchair and have had
lens inplant surgery performed on both eyes. so, if you are a diabetic, or holds a diabetic person
close to your heart, I would strongly advise you read this report or at the very least, please direct
your loved one to see what I have to say here.
My wife of 43 years standing, ... Show more content on Helpwriting.net ...
For some people, these symptoms are mild; in my case, diabetic neuropathy is disabling and painful.
It could be fatal if ignored.
Even though diabetic neuropathy is a common serious complication of diabetes, you can often
prevent or treat diabetic neuropathy or slow its progress with tight blood sugar control and a healthy
lifestyle.
There are four main types of diabetic neuropathy. You may have just one type or symptoms of
several types. Most develop gradually, and you may not notice problems until considerable damage
has occurred.
The signs and symptoms of diabetic neuropathy vary, depending on the type of neuropathy and
which nerves are affected.
PERIPHERAL NEUROPATHY
I have peripheral neuropathy which is the most common form of diabetic neuropathy. Feet and legs
are often affected first, followed by hands and arms. Symptoms of peripheral neuropathy are worse
at night, and may include:
* Numbness or reduced ability to feel pain or temperature changes
* A tingling or burning sensation
* Sharp pains or

Chicken Shingles Essay
Shingles is a painful rash that causes inflammation of the nerves beneath the skin. The rash, caused
by a virus called Varicella–Zoster Virus, which is the same virus that causes the chicken pox. If you
had the chicken pox you are at risk for shingles because the virus stays inactive in your nerve tissue
(The Mayo Clinic, 2016). Unlike a mild case of chicken pox, the shingles virus causes severe pain,
burning, itching, fluid filled blisters, and in rare cases, death (Novatnack, 2007).
Without shingles affecting your nervous system, your dermatomes would be functioning properly
and without pain. A dermatome is in areas of the skin that are supplied by a spinal nerve. They also
help limit neurologic levels and are supplied by the branches of a single dorsal root ganglion. This
means that when functioning properly, a dermatome would be forming connective tissues, and
plainly existing on the spinal nerves. The sensory neurons would be functioning properly, along with
the dorsal root ganglion (Kisgner, 2015).
Once you have the chicken pox, the virus travels from your skin, to the cranial nerves, and then to
your dorsal root ganglion cells. After that, the virus remains dormant. The virus waits until the
setting is ideal in your ... Show more content on Helpwriting.net ...
People who are most commonly at risk are the elderly, patients with HIV; those with cancer, or
organ transplant recipients. Pretty much anyone who has a condition or takes a medication that
suppresses your immune system is at risk (Novatnack, 2007). Common symptoms that arise before
the rash appears are pain, burning, numbness, tingling, and sensitivity to touch. After a few days, a
red rash will form with fluid–filled blisters. The rash that usually develops wraps around either side
of your torso. The rash can even display around your eye or side of the neck or face. Itching is also a
very common symptom of the shingles virus (The Mayo Clinic,

Trigeminal Neuralgia Research Papers
Trigeminal Neuralgia
Trigeminal neuralgia is a nerve disorder that causes attacks of severe facial pain. The attacks last
from a few seconds to several minutes. They can happen for days, weeks, or months and then go
away for months or years. Trigeminal neuralgia is also called tic douloureux.
CAUSES
This condition is caused by damage to a nerve in the face called the trigeminal nerve. An attack can
be triggered by:
Talking.
Chewing.
Putting on makeup.
Washing your face.
Shaving your face.
Brushing your teeth.
Touching your face.
RISK FACTORS
This condition is more likely to develop in:
Women.
People who are 50 years old or older.
SYMPTOMS
The main symptom of this condition is pain in jaw,

Cranial Nerve Palsy
Cranial Nerve Palsy: with an Emphasis on
Sixth Cranial Nerve Palsy
Cranial Nerve Palsy
With an Emphasis on
Sixth Cranial Nerve Palsy
I. What are Cranial Nerves? * Cranial nerves are nerves that come directly from the brain stem in
contrast to spinal nerves which come from segments of the spinal cord. * There are twelve Cranial
nerves in humans that fit this description. * They mainly serve the motor and sensory systems of the
head and neck region; except for the tenth and the eleventh nerve. * These nerves are divided to
provide one or a few specific functions, and all of them can develop problems.
II. Cranial Nerves and Functions * Olfactory Nerve: Smell * Optic Nerve: Vision * ... Show more
* The sixth cranial nerve is responsible for movement of the eyes, and when it malfunctions, serious
problems with the eyes can occur. * Diagnosis of sixth cranial nerve palsy is easy to see but difficult
to find the cause to treat. * Treatment and tests range from nominal fees to expensive. * A sixth
cranial nerve palsy takes six–to–twelve months to completely recover from, and even then, surgery
may be required.
Cranial Nerve Palsy is defined as damage to the cranial nerves or their branches. It is caused by a
number of medical conditions, including diabetes, hypertension, atherosclerosis, trauma, rise in
intracranial pressure, multiple sclerosis, stroke, lumbar puncture, and neurosyphilis. There are
twelve cranial nerves, and each of them can have a malfunction happen to cause some type of
damage. These nerves go directly from the brain to various parts of the head, neck, and trunk, and
some of them are involved in the special senses (such as sight, sound, touch, and taste). Others
control muscles in the face and regulate the glands in the body. The nerves are named and numbered
according to their location, and the order in which they are named and numbered is from the front of
the brain to the back.
Disorders of cranial nerves may affect the connections between cranial nerve centers within the
brain. A disorder may affect one or more nerves at a time, and the presence and

Herpes Zoster Essay
Discuss the presentation, pathophysiology, diagnostic criteria, differential diagnoses, treatment
modalities, and patient education of herpes zoster. Herpes zoster, or shingles, is a viral infection that
results in vesicular lesions on skin, which are typically limited to one side of the body following one
body dermatome (Dunphy, Winland–Brown, Porter, & Thomas, 2015). Herpes zoster is caused by
reactivation of the chickenpox, or varicella–zoster virus. Once an individual is exposed to this virus,
it can remain in the dormant or latent phase for decades. The virus attaches to the dorsal root ganglia
and typically recurs when the body is in a weakened state. It is estimated that as much as 10–20% of
the world's population will experience ... Show more content on Helpwriting.net ...
Unfortunately, current statistics reveal that less than 8% of potential candidates receive this vaccine.
Zostavax as a one–time dose for those previously exposed as a two–dose regime for those never
exposed to Varicella (Lexi–Comp, Inc, 2016). This vaccine can reduce the severity and duration of
attacks by greater than 60% (Lexi–Comp, Inc, 2016). During a time of outbreak, cool compresses of
Burow's solution can remove crusts and ease pain. Oral anti–viral agents should be initiated within
48 hours of rash. There are several choices in this category, including (Lexi–Comp, Inc, 2016)
Valacyclovir 1000mg tid x 7 days
Famciclovir 500mg tid x 7 days
Acyclovir 800mg 5 times daily for 7–10 days (Lexi–Comp, Inc, 2016)
In addition, consideration should be given to corticosteroids, especially in the elderly population.
This would be given at 40mg qd, with a taper of 5mg qd. Postherpatic neuralgia can be treated with
medications such a gabapentin, lidocaine 5% patch, or topically with capsaicin

Trigeminal Neuralgia Research Paper
TRIGEMINAL NEURALGIA
Trigeminal Neuralgia (TGN), also known as Tic Douloureux, is a transient, yet chronic, recurrent
and intense pain in the area of the face covered by the three branches of the Trigeminal Nerve (CN
V). Though the pain can reside around the nose and eyes, it is typically situated in the lower face
and jaw, and is generally restricted to one side of the face. Dubbed the Suicide Disease because of
the significant number of sufferers who resorted to taking their lives because of the unbearable pain,
TGN is considered by many as the most painful physical ailment known to man. The enervating and
intolerable pain is characterized as sporadic, intense, stabbing and electric shock–like. Though the
ailment was first recognized by ... Show more content on Helpwriting.net ...
The Idiopathic typical Trigeminal Neuralgia is attributed by five cardinal features: "Paroxysmal,
Provocable, unilateral pain, confined to trigeminal territory, without loss of pain" (Devi at al., 2015);
A disorder is considered paroxysmal if there are sudden recurrence and intensification of symptoms
(Wikipedia, 2015). The pain from Type 1 is often triggered by a light breeze, cold, vibrations,
brushing of the teeth, shaving, eating and talking. The Atypical Type, on the other hand, is often
bilateral, constant, non–paroxysmal, unprovoked by external stimuli, and less intensified than Type
1 (Devi at al., 2015). Both types of pain may occur in the same patient, and could occasionally be
simultaneous. Symptoms of trigeminal neuralgia comprise a sharp, stabbing twinge on one side of
the face that commonly begins at the angle of the mandible. During an attack, patients are noted to
shield their face to prevent it from being touched by anyone. Sufferers usually experience recurrent
pain every few hours. One attribute that differentiates Trigeminal Neuralgia from Migraines, is that
TGN only occurs when the patient is awake and not

Dolicoectasia Case Study
Our patient presented with a history much typically suggestive of trigeminal neuralgia. Dental
extractions are sometimes considered as the trigger factor for the same. Patient also did not have any
neurological deficits including sensory loss over trigeminal nerve distribution making trigeminal
neuralgia a strong clinical possibility. Trigeminal nerve is defined as per The International
Classification of Headache disorders (ICHD–3), which defines it as brief episodes of sharp, stabbing
pain, in the region supplied by the trigeminal nerve along with supportive diagnostic criteria as three
or more attacks of pain on one side of the face; solely in trigeminal nerve dermatomal distribution;
of severe intensity, referred as electric shock like sensation and recurring as paroxysmal attacks i.e.,
lasting for a fraction of a second to a few minutes. The term dolicoectasia literally means and
elongated, dilated and tortuous artery. According to a study that focused on imaging studies of the
vertebrobasilar artery in order to determine the clinical effects of dolicoectasia, determined that the
basilar artery was considered elongated if at any point, it was lateral to the margin of either the
clivus of dorsum sellae or bifurcated above the plane of the suprasellar cistern. Ectasia of vertebral
artery is defined as diameter of more than 4.5 mm ... Show more content on Helpwriting.net ...
Vertebrobasilar dolicoectasia is an acquired condition, and similar to the clinical course of
varicosities in the lower limb, is invariably progressive. MRI is the preferred means of imaging for
diagnosing the cause of trigeminal neuralgia.4 Also, age and the medical history of the patient can
be the etiological factors causing progression of ectasia, as in our case with HBsAg positive status,
which is known factor responsible for vascular events including ectasia of

Symptoms And Treatment Of Neuropathic Pain
Pain is a complex, unpleasant, and disruptive sensation. The day–to–day pain people experience
from a paper cut or a flu shot results from the activation of nociceptive receptors at the site of tissue
injury, which is known as nociceptive pain. Some individuals also have experience with a different
type of pain, one that is chronic, intractable, disabling, and it arises "as a direct consequence of a
lesion or disease affecting the somatosensory system" (Treede, 2008). This form of pain is
neuropathic pain.
The term neuropathic pain is loosely used in the literature without a well–defined classification
system and it broadly represents any syndromes with an underlying physiologic damage to the pain
transmission pathway (Treede, 2008). The causes of nerve tissue damage in neuropathic pain,
whether peripherally or central, are widespread. They range from nerve destruction during surgery
or trauma to metabolic disturbances, cancer, infectious diseases and other causes (Woolf, 1999).
Common symptoms suggestive of neuropathic pain are spontaneous or provoked sensory
abnormalities such as dysesthesia, paresthesia, allodynia, as well as complete sensory deficit in
some cases. A few types of neuropathic pain with manifestations in the head and neck region are
trigeminal neuralgia, glossopharyngeal neuralgia, post–herpetic neuralgia and atypical facial pain.
Dentists are in a unique position where they are challenged on an almost daily basis to diagnose and
treat pain in the orofacial

Trigeminal Reflexes
According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic
pain assessment and the American Acade–my of Neurology (AAN)–EFNS guidelines on TN
management (Cruccu G et al., 2006) the neurophysiological recording of trigeminal reflexes
represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains.
(Figure 1.1). In patients presented with pain in the trigeminal territory, trigeminal reflexes offer the
clinician with useful information. Abnormalities are often discovered in divi–sions that appear
clinically unaffected. An objective demonstration of dysfunction is provided in all patients with pain
secondary to a docu–mented disease, such as symptomatic trigeminal neuralgia, ... Show more
They are also special regarding the lesions in which they are involved, both at the peripheral level
because of the suscep–tibility of some terminal branches, and at the nuclei because of their large size
and the large amount of connections with other centers. Conventional magnetic resonance imaging
studies are often not suffi–ciently informative to demonstrate very tiny lesions that could be re–
sponsible for an important damage in the brainstem. . Therefore, clini–cal neurophysiology and
specifically, the techniques used in the study of the trigeminal functions, remain as convenient
diagnostic and re–search tools to document clinically evident lesions or uncover subclini–cal
abnormalities. Therefore, an abnormality in the excitability recov–ery of the R2 component with no
changes in that of the R1 component would indicate a disorder of the excitability of brainstem
interneurons mediating the R2 component.(Veciana M et al., 2005). Electromyographic (EMG)
investigation of the trigeminal nerve reflex–es, including the blink reflex, may provide valuable
additional infor–mation about the site of a lesion that cannot be obtained with physical information
(Pardal–Fernandez JM et al., 2009). When accurate lo–calization of a lesion is possible with EMG,
more tailored MRI exami–nations might be possible, limiting MR imaging

The Suicide Disease : Trigeminal Neuralgia
The Suicide Disease, otherwise known as Trigeminal Neuralgia, is a neuropathic disorder that does
not often emerge until after the age of fifty. Due to the lack of a cure and the random and
inescapable searing pains in parts of the face, many patients opt for suicide. Trigeminal Neuralgia is
one of the most painful neuropathic disorders known today. It attacks the trigeminal nerve,
consisting of the fifth cranial pair: a minor motor root and a major sensory root (Leclercq, 2015, p.
994). The pain that a patient experiences stems from complications within the branches of this
specific pair of nerves (Zakrzewska, 2015, p.1).
Although there is a possible genetic cause linked to this disorder, very few people with Trigeminal
Neuralgia have family members that develop the disorder as well. It is estimated that the correlation
is roughly five percent, with the mean age of emergence being 51.2. (Kumar, 2013, p. 383). This
neurological disorder is considered rather rare. Per 100,000 people, Trigeminal Neuralgia only
affects roughly three to twenty–seven people in the United States (Missios, 2014, p. 751). Like most
aspects of this disorder, the lines of heredity and prevalence are relatively blurry. Through a further
exploration of the etiology, symptoms, and possible treatments of Trigeminal Neuralgia, researchers
are getting closer to solving the unanswered questions of the Suicide Disease.
The most well–known cause of this disorder is neurovascular compression. The causes of

Facial Atypical Pain Syndrome
A review of the records reveals the member to be an adult male with a birth date of 04/24/1985. In
03/2013, the member had a brain stem stroke due to vertebral dissection. Six to nine months
following the stroke the member developed facial atypical pain syndrome; the pain has been
worsening. His provider, Peter Konrad, M.D. has recommended a neurostimulator implantation.
The carrier has denied coverage of a neurostimulator implantation as not medically necessary. There
is a letter to the member from the carrier dated 03/10/16. In the letter, the carrier states in part:
"According to the Medical Director Review, the request for placement of neurostimulator for deep
brain stimulation(DBS)(an implanted device that sends electrical signals ... Show more content on
Helpwriting.net ...
This technology is the same as that used for dorsal column stimulation which has been validated for
for chronic pain syndrome, failed back syndrome and peripheral neuropathic pain[5]. The pilot study
is being performed at the Cleveland Clinic for DBS[6]. Studies have been performed for motor
cortical stimulation[7]. Results are variable but promising. Technique varies from institution to
institution and a consensus is yet to be reached . Given the dire nature of intractable neuropathic
face pain, the lack of effective therapy and reported efficacy of neuromodulation surgery, it is
reasonable to offer DBS or MCS in carefully chosen

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Medical Marijuana Argumentative Analysis