This presentation by Professor Joanna Zakrzewska, Head of facial pain unit at Eastman Dental Hospital, looks at trigeminal neuralgia in MS and how it's diagnosed and managed.
It was presented at the MS Trust Annual Conference in November 2014.
Supportive periodontal therapy (SPT) involves long-term maintenance programs following active periodontal treatment to maintain periodontal health. SPT involves periodic examination, motivation and instrumentation of sites showing inflammation, treatment of reinfected sites, and polishing. It begins after active treatment and is aimed at preventing recurrence through early detection of disease. The frequency of SPT visits depends on the patient's periodontal risk assessment but generally occurs every 3-4 months. It can be performed by general dentists or specialists depending on the extent of original periodontal destruction. Adjunctive use of antimicrobials may also be included in SPT.
The document outlines the phases and procedures involved in developing and implementing a treatment plan for periodontal therapy. It discusses establishing diagnoses and prognoses, designing a master plan that sequences nonsurgical and surgical treatments, restorative work, maintenance, and addressing systemic factors. The goal is to create a healthy periodontium and functioning dentition through elimination of irritants and correction of underlying issues causing inflammation and tissue destruction.
Case history & diagnosis in periodontics /certified fixed orthodontic course...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Differential diagnosis of orofacial painsailesh kumar
Differential diagnosis of orofacial pain can be divided into acute and chronic categories. Acute pain includes dental, periodontal, sinus, and salivary gland issues and is usually inflammatory in origin. Chronic pain includes myofascial pain, TMJ disorders, migraines, and various neuropathies. Neuropathic pain includes trigeminal neuralgia, postherpetic neuralgia, glossopharyngeal neuralgia, and complex regional pain syndrome. Management depends on the underlying cause and includes medications, physical therapy, and occasionally surgery.
This document discusses advances in periodontal diagnosis, from early methods relying on physical signs and symptoms to newer techniques utilizing technology. It covers developments in clinical diagnosis including tools to assess inflammation like gingival bleeding tests and crevicular fluid flow measurements. Advances in imaging like dental X-rays are discussed. The document also explores emerging ways of characterizing host response and genetic factors. A significant portion reviews the evolution of periodontal probes from manual to electronic versions that provide more standardized, precise measurements.
This document provides an overview of abscesses of the periodontium, specifically focusing on periodontal abscesses. It defines a periodontal abscess and classifies them based on location, course, number, affected tissue, and cause. Periodontal abscesses are most prevalent in molar sites and those with pre-existing periodontal pockets. They can be caused by factors like untreated periodontitis, foreign bodies, or changes after periodontal procedures or antibiotics. The pathogenesis involves bacterial entry triggering an inflammatory response that leads to tissue destruction and pus formation.
The document discusses various methods for evaluating periodontal regeneration after therapy, including clinical, radiographic, surgical re-entry, and histologic methods. It also covers principles of bone regeneration including osteogenesis, osteoconduction and osteoinduction. Non-bone graft associated procedures and bone grafting techniques and materials used in periodontal regeneration are described in detail.
This document outlines the dental management of patients with thyroid disease. It discusses taking a thorough medical history and examination. Treatment plans should consider the patient's thyroid condition and medications. Hyperthyroidism can increase risks of infection, bleeding, and cardiac issues while hypothyroidism increases infection risk. Dental procedures should minimize stress and avoid epinephrine for uncontrolled hyperthyroid patients. Vital signs must be monitored and treatment stopped if issues arise.
Supportive periodontal therapy (SPT) involves long-term maintenance programs following active periodontal treatment to maintain periodontal health. SPT involves periodic examination, motivation and instrumentation of sites showing inflammation, treatment of reinfected sites, and polishing. It begins after active treatment and is aimed at preventing recurrence through early detection of disease. The frequency of SPT visits depends on the patient's periodontal risk assessment but generally occurs every 3-4 months. It can be performed by general dentists or specialists depending on the extent of original periodontal destruction. Adjunctive use of antimicrobials may also be included in SPT.
The document outlines the phases and procedures involved in developing and implementing a treatment plan for periodontal therapy. It discusses establishing diagnoses and prognoses, designing a master plan that sequences nonsurgical and surgical treatments, restorative work, maintenance, and addressing systemic factors. The goal is to create a healthy periodontium and functioning dentition through elimination of irritants and correction of underlying issues causing inflammation and tissue destruction.
Case history & diagnosis in periodontics /certified fixed orthodontic course...Indian dental academy
Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients
State of the art comprehensive training-Faculty of world wide repute &Very affordable.
Differential diagnosis of orofacial painsailesh kumar
Differential diagnosis of orofacial pain can be divided into acute and chronic categories. Acute pain includes dental, periodontal, sinus, and salivary gland issues and is usually inflammatory in origin. Chronic pain includes myofascial pain, TMJ disorders, migraines, and various neuropathies. Neuropathic pain includes trigeminal neuralgia, postherpetic neuralgia, glossopharyngeal neuralgia, and complex regional pain syndrome. Management depends on the underlying cause and includes medications, physical therapy, and occasionally surgery.
This document discusses advances in periodontal diagnosis, from early methods relying on physical signs and symptoms to newer techniques utilizing technology. It covers developments in clinical diagnosis including tools to assess inflammation like gingival bleeding tests and crevicular fluid flow measurements. Advances in imaging like dental X-rays are discussed. The document also explores emerging ways of characterizing host response and genetic factors. A significant portion reviews the evolution of periodontal probes from manual to electronic versions that provide more standardized, precise measurements.
This document provides an overview of abscesses of the periodontium, specifically focusing on periodontal abscesses. It defines a periodontal abscess and classifies them based on location, course, number, affected tissue, and cause. Periodontal abscesses are most prevalent in molar sites and those with pre-existing periodontal pockets. They can be caused by factors like untreated periodontitis, foreign bodies, or changes after periodontal procedures or antibiotics. The pathogenesis involves bacterial entry triggering an inflammatory response that leads to tissue destruction and pus formation.
The document discusses various methods for evaluating periodontal regeneration after therapy, including clinical, radiographic, surgical re-entry, and histologic methods. It also covers principles of bone regeneration including osteogenesis, osteoconduction and osteoinduction. Non-bone graft associated procedures and bone grafting techniques and materials used in periodontal regeneration are described in detail.
This document outlines the dental management of patients with thyroid disease. It discusses taking a thorough medical history and examination. Treatment plans should consider the patient's thyroid condition and medications. Hyperthyroidism can increase risks of infection, bleeding, and cardiac issues while hypothyroidism increases infection risk. Dental procedures should minimize stress and avoid epinephrine for uncontrolled hyperthyroid patients. Vital signs must be monitored and treatment stopped if issues arise.
Doxycycline gel and minocycline microspheres provide clinical significance as adjuncts to scaling and root planing (SRP) for periodontitis treatment by demonstrating improvements in probing depth (PD) and clinical attachment level (CAL) that are clinically meaningful based on established criteria. While morbidity is low for all treatments, local drug delivery can reduce total treatment time and may offset increased costs by reducing need for surgery.
Trigeminal neuralgia is a disorder causing severe facial pain. It affects branches of the trigeminal nerve, the largest cranial nerve. The pain is usually sudden, severe, and described as electric shock-like. It is commonly triggered by trivial stimuli like talking or brushing teeth. Treatment options include medications like carbamazepine or surgery to decompress the trigeminal nerve if medications do not provide relief from pain.
Trigeminal neuralgia is a chronic pain disorder characterized by severe, sporadic facial pain. It is caused by damage or compression of the trigeminal nerve. The pain is described as electric shock-like and is often triggered by trivial stimuli like tooth brushing or talking. Diagnosis is based on clinical history and examination. Treatment involves drug therapy with anticonvulsants like carbamazepine or surgery like radiofrequency lesioning or microvascular decompression to relieve nerve compression. Surgery provides long-term pain relief in the majority of patients but carries more risks than drug therapy.
This document discusses the procedure of pulp revascularization to treat immature permanent teeth with necrotic pulps and open apices. It involves disinfecting the root canal with calcium hydroxide or triple antibiotic paste, inducing bleeding into the canal to form a blood clot, and placing MTA over the clot to allow new tissue and blood vessel formation. This results in continued root development, thickening of dentin walls, and closure of the root apex. Advantages include natural root maturation and vital tooth structure, while disadvantages can include discoloration or resistant bacterial infection.
Orofacial pain can be somatic, neuropathic, or psychogenic in origin. Somatic pain results from stimuli affecting structures like teeth, skin or bone and is usually acute and localized. Neuropathic pain is abnormal nerve pain that may be paroxysmal or continuous, as seen in trigeminal neuralgia. Psychogenic pain has no physical cause and is characterized as diffuse, chronic pain that worsens with stress. Common causes of orofacial pain include dental diseases, sinusitis, temporomandibular joint disorders, and neurological conditions like trigeminal neuralgia.
The document discusses the use of steroids in dentistry. It begins by explaining what steroids are and how they are produced naturally in the body and can also be synthesized. In dentistry, steroids are commonly used as anti-inflammatory drugs to control pain and treat oral diseases. The document then discusses the structures of steroids and the different types that are produced in the body. It provides details on the mechanisms of action of both glucocorticoids and mineralocorticoids. Finally, it discusses the use of topical, intralesional and systemic steroids for treating various oral diseases like recurrent aphthous ulcers, lichen planus, erythema multiforme and pemphigus
Atypical facial pain is a chronic facial discomfort or pain of unknown cause that typically affects middle-aged or older women. It is characterized by a dull, burning pain of ill-defined location with no objective signs or positive test results. The pathogenesis is unclear but may involve extreme stress, enhanced cerebral activity, and cell damage. Diagnosis involves ruling out other conditions through medical history, examination, and negative imaging and blood tests. Treatment can be challenging as the condition often does not respond well to interventions.
The document discusses piezoelectric surgery, which uses ultrasonic microvibrations from piezoelectric inserts to cut bone precisely while sparing soft tissues. Key points:
1. Piezoelectric surgery was invented in 1988 and uses modulated ultrasonic frequencies (25-30 kHz) to cut mineralized tissue selectively.
2. It allows for precise cuts with less bleeding and better visibility due to cavitation. Post-operative pain and healing time are reduced compared to traditional techniques.
3. Indications include various dental and medical procedures like sinus lifts, grafting and extractions where selective bone cuts are needed to protect adjacent soft tissues.
The document discusses keratinization of the gingiva. It describes the process of keratinization which involves the differentiation of basal epithelial cells into keratinocytes that migrate upward and undergo maturation. The layers of keratinized epithelium are described along with the cytokeratins and other proteins involved in keratinization. The clinical significance of keratinization in protecting the gingiva and maintaining health is summarized.
Trigeminal neuralgia is a neuropathic facial pain condition caused by compression or irritation of the trigeminal nerve, resulting in intense electric shock-like pain. It typically affects those over 50 years old and treatment involves medications initially, with surgical options like microvascular decompression or rhizotomy considered if medications fail to control pain. The document discusses the anatomy, classification, symptoms, diagnosis, differential diagnosis, and treatment approaches for trigeminal neuralgia.
The document discusses various chairside diagnostic aids that can be used in periodontal examination. It outlines the limitations of traditional diagnostic methods like clinical and radiographic evaluation. It then describes several advanced diagnostic aids like thermal probes, subtraction radiography. The rationale for developing chairside diagnostic kits is provided which allow immediate reports without specialized equipment. Examples of microbiological, genetic and biochemical chairside test kits are explained in detail, covering their methodology and biomarkers analyzed. Newer diagnostic tests still under development are also mentioned.
Dentists play an important role in the diagnosis and management of desquamative gingivitis. The importance of being able to recognise and properly diagnose this condition is accentuated by the fact that a serious and life threatening disease may initially manifest as desquamative gingivitis.
periodontal management of medically compromised patientsVishal Mishra
This document summarizes periodontal management considerations for various medically compromised patients. It covers cardiovascular diseases, renal diseases, pulmonary diseases, immunosuppression/chemotherapy, radiotherapy, endocrine disorders, and hemorrhagic/blood disorders. For each condition, it discusses precautions, management of dental treatment, and management of medical emergencies that could arise during treatment. The goal is to minimize risk and stress for patients with underlying medical conditions.
Inflammatory papillary hyperplasia and ranula are conditions involving the oral mucosa. Inflammatory papillary hyperplasia involves the palate and presents as numerous red papillary projections, often caused by an ill-fitting denture. Treatment involves improving denture fit or removing excess tissue. Ranula is a fluid-filled cyst in the floor of the mouth associated with salivary gland ducts. It appears as a blue, dome-shaped swelling and is usually treated with surgical removal of the involved salivary gland. Both conditions can involve histological examination to understand the epithelial lining and tissue characteristics.
This document summarizes various endocrine problems and their oral manifestations. It discusses conditions like pregnancy, menopause, Addison's disease, Cushing's syndrome, hyperthyroidism, hypothyroidism, diabetes mellitus, and renal diseases. Specific oral signs and symptoms are provided for each condition, such as gingival changes during pregnancy, melanotic pigmentation in Addison's disease, and dry mouth in diabetes. Management strategies are also briefly outlined.
This document provides information on antibiotics used in periodontics. It begins by defining antibiotics and their mechanisms of action. An ideal antibiotic should be selective against microorganisms, bactericidal, not induce resistance, and have minimal adverse effects. Antibiotics are classified based on their chemical structure and include sulfonamides, quinolones, tetracyclines, aminoglycosides, macrolides, beta-lactams, nitroimidazoles, and others. Common antibiotics used in periodontics include tetracycline, metronidazole, amoxicillin, clindamycin, and cephalosporins. Locally delivered antibiotics like Atridox and Actisite provide
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
This document discusses supportive periodontal therapy (SPT). It begins with an introduction and overview of SPT. It then discusses the rationale and objectives of SPT, which include preventing disease recurrence and progression. Compliance is important for effective SPT. The document outlines the typical parts of an SPT visit, including examination, motivation and instrumentation, treatment of reinfected sites, and determination of recall interval. Research shows that regular SPT every 3-6 months is effective at preventing further attachment and bone loss. The document also discusses classifying post-treatment patients, referring patients to specialists, assessing risk of disease recurrence, and complications of SPT.
Trigeminal neuralgia is a painful condition of the trigeminal nerve that causes sudden, severe facial pain. It occurs most often in older women and can be triggered by activities like chewing or brushing teeth. The pain is often described as burning or shock-like. While the cause is unknown, it may involve compression of the trigeminal nerve by blood vessels. Treatment involves medications like carbamazepine or surgery to decompress the nerve or destroy parts of it to relieve pain. The diagnostic process aims to rule out other potential causes of facial pain through imaging and neurological evaluation.
Facial pain due to TMJ, trigminal neuralgia, Sjogren syndrome, Eagles etc..Nelson Hendler
This lecture covers the most common sources of facial pain, including trigeminal neuralgia, TMJ, Sjogren's, Eagles syndrome, glossopharyngeal neuralgia and other..This is based on a lecture on facial pain, given at University of Maryland School of Dental Surgery
Doxycycline gel and minocycline microspheres provide clinical significance as adjuncts to scaling and root planing (SRP) for periodontitis treatment by demonstrating improvements in probing depth (PD) and clinical attachment level (CAL) that are clinically meaningful based on established criteria. While morbidity is low for all treatments, local drug delivery can reduce total treatment time and may offset increased costs by reducing need for surgery.
Trigeminal neuralgia is a disorder causing severe facial pain. It affects branches of the trigeminal nerve, the largest cranial nerve. The pain is usually sudden, severe, and described as electric shock-like. It is commonly triggered by trivial stimuli like talking or brushing teeth. Treatment options include medications like carbamazepine or surgery to decompress the trigeminal nerve if medications do not provide relief from pain.
Trigeminal neuralgia is a chronic pain disorder characterized by severe, sporadic facial pain. It is caused by damage or compression of the trigeminal nerve. The pain is described as electric shock-like and is often triggered by trivial stimuli like tooth brushing or talking. Diagnosis is based on clinical history and examination. Treatment involves drug therapy with anticonvulsants like carbamazepine or surgery like radiofrequency lesioning or microvascular decompression to relieve nerve compression. Surgery provides long-term pain relief in the majority of patients but carries more risks than drug therapy.
This document discusses the procedure of pulp revascularization to treat immature permanent teeth with necrotic pulps and open apices. It involves disinfecting the root canal with calcium hydroxide or triple antibiotic paste, inducing bleeding into the canal to form a blood clot, and placing MTA over the clot to allow new tissue and blood vessel formation. This results in continued root development, thickening of dentin walls, and closure of the root apex. Advantages include natural root maturation and vital tooth structure, while disadvantages can include discoloration or resistant bacterial infection.
Orofacial pain can be somatic, neuropathic, or psychogenic in origin. Somatic pain results from stimuli affecting structures like teeth, skin or bone and is usually acute and localized. Neuropathic pain is abnormal nerve pain that may be paroxysmal or continuous, as seen in trigeminal neuralgia. Psychogenic pain has no physical cause and is characterized as diffuse, chronic pain that worsens with stress. Common causes of orofacial pain include dental diseases, sinusitis, temporomandibular joint disorders, and neurological conditions like trigeminal neuralgia.
The document discusses the use of steroids in dentistry. It begins by explaining what steroids are and how they are produced naturally in the body and can also be synthesized. In dentistry, steroids are commonly used as anti-inflammatory drugs to control pain and treat oral diseases. The document then discusses the structures of steroids and the different types that are produced in the body. It provides details on the mechanisms of action of both glucocorticoids and mineralocorticoids. Finally, it discusses the use of topical, intralesional and systemic steroids for treating various oral diseases like recurrent aphthous ulcers, lichen planus, erythema multiforme and pemphigus
Atypical facial pain is a chronic facial discomfort or pain of unknown cause that typically affects middle-aged or older women. It is characterized by a dull, burning pain of ill-defined location with no objective signs or positive test results. The pathogenesis is unclear but may involve extreme stress, enhanced cerebral activity, and cell damage. Diagnosis involves ruling out other conditions through medical history, examination, and negative imaging and blood tests. Treatment can be challenging as the condition often does not respond well to interventions.
The document discusses piezoelectric surgery, which uses ultrasonic microvibrations from piezoelectric inserts to cut bone precisely while sparing soft tissues. Key points:
1. Piezoelectric surgery was invented in 1988 and uses modulated ultrasonic frequencies (25-30 kHz) to cut mineralized tissue selectively.
2. It allows for precise cuts with less bleeding and better visibility due to cavitation. Post-operative pain and healing time are reduced compared to traditional techniques.
3. Indications include various dental and medical procedures like sinus lifts, grafting and extractions where selective bone cuts are needed to protect adjacent soft tissues.
The document discusses keratinization of the gingiva. It describes the process of keratinization which involves the differentiation of basal epithelial cells into keratinocytes that migrate upward and undergo maturation. The layers of keratinized epithelium are described along with the cytokeratins and other proteins involved in keratinization. The clinical significance of keratinization in protecting the gingiva and maintaining health is summarized.
Trigeminal neuralgia is a neuropathic facial pain condition caused by compression or irritation of the trigeminal nerve, resulting in intense electric shock-like pain. It typically affects those over 50 years old and treatment involves medications initially, with surgical options like microvascular decompression or rhizotomy considered if medications fail to control pain. The document discusses the anatomy, classification, symptoms, diagnosis, differential diagnosis, and treatment approaches for trigeminal neuralgia.
The document discusses various chairside diagnostic aids that can be used in periodontal examination. It outlines the limitations of traditional diagnostic methods like clinical and radiographic evaluation. It then describes several advanced diagnostic aids like thermal probes, subtraction radiography. The rationale for developing chairside diagnostic kits is provided which allow immediate reports without specialized equipment. Examples of microbiological, genetic and biochemical chairside test kits are explained in detail, covering their methodology and biomarkers analyzed. Newer diagnostic tests still under development are also mentioned.
Dentists play an important role in the diagnosis and management of desquamative gingivitis. The importance of being able to recognise and properly diagnose this condition is accentuated by the fact that a serious and life threatening disease may initially manifest as desquamative gingivitis.
periodontal management of medically compromised patientsVishal Mishra
This document summarizes periodontal management considerations for various medically compromised patients. It covers cardiovascular diseases, renal diseases, pulmonary diseases, immunosuppression/chemotherapy, radiotherapy, endocrine disorders, and hemorrhagic/blood disorders. For each condition, it discusses precautions, management of dental treatment, and management of medical emergencies that could arise during treatment. The goal is to minimize risk and stress for patients with underlying medical conditions.
Inflammatory papillary hyperplasia and ranula are conditions involving the oral mucosa. Inflammatory papillary hyperplasia involves the palate and presents as numerous red papillary projections, often caused by an ill-fitting denture. Treatment involves improving denture fit or removing excess tissue. Ranula is a fluid-filled cyst in the floor of the mouth associated with salivary gland ducts. It appears as a blue, dome-shaped swelling and is usually treated with surgical removal of the involved salivary gland. Both conditions can involve histological examination to understand the epithelial lining and tissue characteristics.
This document summarizes various endocrine problems and their oral manifestations. It discusses conditions like pregnancy, menopause, Addison's disease, Cushing's syndrome, hyperthyroidism, hypothyroidism, diabetes mellitus, and renal diseases. Specific oral signs and symptoms are provided for each condition, such as gingival changes during pregnancy, melanotic pigmentation in Addison's disease, and dry mouth in diabetes. Management strategies are also briefly outlined.
This document provides information on antibiotics used in periodontics. It begins by defining antibiotics and their mechanisms of action. An ideal antibiotic should be selective against microorganisms, bactericidal, not induce resistance, and have minimal adverse effects. Antibiotics are classified based on their chemical structure and include sulfonamides, quinolones, tetracyclines, aminoglycosides, macrolides, beta-lactams, nitroimidazoles, and others. Common antibiotics used in periodontics include tetracycline, metronidazole, amoxicillin, clindamycin, and cephalosporins. Locally delivered antibiotics like Atridox and Actisite provide
Furcation involvement is a common sequela of severe chronic periodontal disease. Its effective management has a profound influence on the outcome of periodontal therapy.
This document discusses supportive periodontal therapy (SPT). It begins with an introduction and overview of SPT. It then discusses the rationale and objectives of SPT, which include preventing disease recurrence and progression. Compliance is important for effective SPT. The document outlines the typical parts of an SPT visit, including examination, motivation and instrumentation, treatment of reinfected sites, and determination of recall interval. Research shows that regular SPT every 3-6 months is effective at preventing further attachment and bone loss. The document also discusses classifying post-treatment patients, referring patients to specialists, assessing risk of disease recurrence, and complications of SPT.
Trigeminal neuralgia is a painful condition of the trigeminal nerve that causes sudden, severe facial pain. It occurs most often in older women and can be triggered by activities like chewing or brushing teeth. The pain is often described as burning or shock-like. While the cause is unknown, it may involve compression of the trigeminal nerve by blood vessels. Treatment involves medications like carbamazepine or surgery to decompress the nerve or destroy parts of it to relieve pain. The diagnostic process aims to rule out other potential causes of facial pain through imaging and neurological evaluation.
Facial pain due to TMJ, trigminal neuralgia, Sjogren syndrome, Eagles etc..Nelson Hendler
This lecture covers the most common sources of facial pain, including trigeminal neuralgia, TMJ, Sjogren's, Eagles syndrome, glossopharyngeal neuralgia and other..This is based on a lecture on facial pain, given at University of Maryland School of Dental Surgery
This document discusses trigeminal neuralgia, a neuropathic pain condition that causes severe, sporadic facial pain. It provides information on:
1) The etiology, including neurovascular compression as a common cause.
2) Symptoms like brief, severe facial pain that may be triggered by light touch.
3) Treatment options like carbamazepine, microvascular decompression surgery, and percutaneous radiofrequency thermocoagulation of the gasserian ganglion.
4) Imaging techniques like MRI that can identify compressive vascular structures.
This document discusses trigeminal neuralgia (TN), a painful neurological condition that causes severe, sporadic facial pain. It begins with background on TN, describing its distinctive clinical history and pain patterns. The document then covers TN's anatomy and potential pathophysiologies, risk factors, characteristics, treatment options, complications, and prognosis over time. TN is caused by compression or irritation of the trigeminal nerve and presents as sudden, severe facial pain that may be triggered by everyday activities like chewing. While medication can provide initial relief, over time additional treatments like surgery may be needed to control breakthrough pain from this disabling condition.
Trigeminal neuralgia is a neuropathic facial pain condition characterized by sudden, severe, brief stabbing pains in the face that are triggered by everyday activities like eating or talking. The pain is caused by abnormalities in the trigeminal nerve that transmits sensations from the face to the brain. Carbamazepine is first-line pharmacological treatment to slow nerve signaling, providing pain relief. When medications fail to control pain, surgical options like microvascular decompression or gamma knife radiosurgery aim to decompress the trigeminal nerve from vascular compression. Proper diagnosis involves distinguishing TN from other facial pain conditions through evaluation of pain characteristics, triggers, and response to treatments.
This document provides information on trigeminal neuralgia, including its definition, classification, causes, and treatment. It defines trigeminal neuralgia as a disorder characterized by episodes of intense pain in the face originating from the trigeminal nerve. It classifies different types of neuralgia and lists common causes as damage to nerves from factors like old age, infection, or pressure. For trigeminal neuralgia specifically, it describes the condition as severe, brief attacks of pain in the face triggered by activities like chewing or talking. Treatment options discussed include carbamazepine and other medications as first-line treatment, with surgery like microvascular decompression for severe cases not helped by drugs.
This document discusses various types of neuralgias, focusing on trigeminal neuralgia. It defines neuralgia as severe pain along a nerve distribution. The main types discussed are trigeminal, paratrigeminal, sphenopalatine, glossopharyngeal, geniculate, occipital and postherpetic neuralgias. Trigeminal neuralgia is described as the most common and involves sudden, severe pain in the trigeminal nerve distribution. Causes, clinical features, investigations, management including pharmacological treatments and surgeries are summarized for each type of neuralgia.
MPDS, or myofascial pain disorder syndrome, is a pain disorder characterized by unilateral pain referred from trigger points in muscles of the head and neck. These trigger points are localized tender areas within taut muscle bands caused by micro- or macro-trauma to the musculoskeletal system. Accumulation of chemicals like lactic acid and prostaglandins in the muscles lowers the pain threshold, leading to MPDS symptoms like pain, limited jaw motion, and joint noises. Diagnosis involves assessing range of motion, palpating muscles for tenderness, and grading joint clicks. Treatment aims to inactivate trigger points, prevent recurrence, and correct perpetuating factors through therapies like physical modalities, anesthesia, pharmacotherapy, and occasionally
Prof Joanna Zakrzewska - Trigeminal neuralgia in MS patientsMS Trust
This document summarizes a presentation on trigeminal neuralgia (TN) in patients with multiple sclerosis (MS). Some key points:
- TN occurs in 2-4% of MS patients, who may experience more constant, bilateral pain compared to other TN patients.
- Diagnosis involves investigating potential causes like neurovascular compression through MRI and ruling out other conditions.
- Treatment includes carbamazepine, oxcarbazepine and other medications, as well as ablative surgical procedures for refractory cases.
- More research is needed on the prevalence and management of TN specifically in MS patients compared to other populations.
Role of head and neck imaging preview in patient with trigeminal neuralgia /c...Indian dental academy
This document discusses head and neck imaging for patients with trigeminal neuralgia. It provides details on the course of the trigeminal nerve and branches. Common causes of trigeminal neuralgia include neurovascular compression, tumors, multiple sclerosis, and vascular abnormalities. Imaging plays an important role in the diagnosis and evaluation of trigeminal neuralgia. MRI is often the preferred imaging method as it can directly depict the trigeminal nerve and show compression from neighboring vessels. 3D CISS MRI provides high resolution images of both arteries and veins. Imaging is used to identify compressive lesions and rule out other causes of facial pain such as tumors.
1. The document discusses various types of orofacial pain including somatic, neurogenic, and psychogenic pain. It describes trigeminal neuralgia as a common type of neurogenic pain characterized by sharp, electric shock-like pain in the face that is triggered by stimulation of specific trigger zones. 2. Evaluation of orofacial pain involves taking a thorough medical history and performing physical and neurological examinations. Differential diagnosis considers local causes as well as neurological disorders. 3. Treatment depends on the underlying cause but may include medications, nerve blocks, surgery, or a combination. Carbamazepine is first-line treatment for trigeminal neuralgia.
This document discusses orofacial pain and neuralgias. It defines pain and states that approximately 40% of the British population only visit dentists for pain relief. It then lists and describes various types of orofacial pain including those related to dental issues, jaw diseases, edentulism, postoperative issues, pain triggered by chewing, neurological diseases like trigeminal neuralgia, and atypical facial pain. It provides details on diagnosing and treating specific conditions like trigeminal neuralgia and Bell's palsy.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
Trigeminal neuralgia is a condition characterized by severe, sporadic facial pain. It has been described and studied historically since the 2nd century AD. Modern management involves drug therapies like carbamazepine as first line treatment. When medications fail, various surgical procedures can be used including percutaneous glycerol rhizotomy, balloon compression, and radiofrequency rhizotomy. These aim to destroy nerve fibers supplying the trigeminal ganglion to relieve facial pain from trigeminal neuralgia.
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and
offering a wide range of dental certified courses in different formats.for more details please visit
www.indiandentalacademy.com
The trigeminal nerve is the largest cranial nerve. It contains both sensory and motor fibers and has three divisions - the ophthalmic, maxillary, and mandibular nerves. The trigeminal nerve transmits sensory information from the face and motor commands to the muscles of mastication. It has both sensory and motor roots and ganglia in the gasserian ganglion and pterygopalatine ganglion that relay signals to and from the brain.
Trigeminal neuralgia new classification and diagnostic grading forsandra mosses
This document proposes a new classification system for trigeminal neuralgia (TN) to address inconsistencies in existing criteria. The new system defines TN as orofacial pain restricted to one or more trigeminal nerve divisions. It also adds a diagnostic grading for certainty. This aims to improve communication between patients, physicians and researchers, and help triage patients for therapy and clinical trials. The classification is based on a review of TN's clinical and etiological features to account for common differential diagnoses. It provides defined diagnostic criteria with a grading system for neuropathic pain.
Trigeminal neuralgia is a neuropathic disorder characterized by severe, sporadic facial pain. It is caused most commonly by vascular compression of the trigeminal nerve near the brainstem. Carbamazepine is first-line medical treatment but has side effects. Interventional treatments include microvascular decompression, rhizotomy, and gamma knife radiosurgery which provide initial pain relief in the majority but have risks of sensory deficits. Treatment is aimed at pain control and improving quality of life.
an overview of muscle pain disorder which regularly create some discomfort for patient to live a normal life as well as to the doctor regarding diagnosis of the problem.
This document discusses the history, definition, etiology, clinical characteristics, diagnostic methods, and treatment of myofascial pain dysfunction syndrome (MPDS). Some key points:
- MPDS is a pain disorder caused by trigger points in the muscles of mastication that refer pain to the head and neck. It is the most common cause of masticatory pain.
- Etiology may include occlusal factors, prosthetic problems, malocclusion, psychophysiologic factors, and trauma.
- Clinical characteristics include pain in the head/neck, limited jaw motion, joint noises, and tender muscles.
- Treatment involves a multidisciplinary approach including medications, trigger point injections, physical
Trigeminal neuralgia is a painful facial nerve condition that sometimes occurs in multiple sclerosis patients. The document discusses the epidemiology, diagnosis, and management of trigeminal neuralgia. It provides details on the characteristics of trigeminal neuralgia pain, the various drug and surgical treatment options, and outlines remaining research questions regarding how trigeminal neuralgia presents and is treated in multiple sclerosis patients specifically. The goal is to determine if current trigeminal neuralgia treatment guidelines apply to those with multiple sclerosis and how best to manage their pain.
Neuropathic pain poses a challenge to effective rehabilitation. Best practice, considerations & the use of Action Potential Simulation therapy to effectively treat neuropathic pain, sharing our results from a 2 year research project in people with MS.
Neuropathic pain poses a challenge to effective rehabilitation. Best practice, considerations & the use of Action Potential Simulation therapy to effectively treat neuropathic pain, sharing our results from a 2 year research project in people with MS.
craniofacial_pain EXCELLENTSLIDES PLUS TRIGEMINAL.pptDeniseMathre1
This document provides information on the diagnosis and management of craniofacial pain. It begins by emphasizing the importance of establishing the correct diagnosis, as the wrong diagnosis can lead to wrong treatment. It then covers various pain syndromes involving the face and head, including neuropathic, headache and dental conditions. The document discusses the pharmacological and surgical treatment options for craniofacial pain in detail, focusing on antiepileptic drugs, antidepressants, opioids, botulinum toxin injections, and peripheral nerve stimulation techniques. It stresses that successful treatment depends on making an accurate diagnosis of the underlying cause of the patient's pain.
This document discusses migraine, including:
- Migraine affects 324 million people worldwide and is the 19th most disabling disease.
- Migraine prevalence is highest in women ages 25-55 and it is ranked 4th in India for years lived with disability.
- The pathophysiology of migraine involves hyperexcitability of the brainstem and release of neurotransmitters that activate pain pathways and cause vasodilation.
- Diagnosis is based on patient history meeting diagnostic criteria, and differential diagnosis excludes other causes through tests like CT/MRI if needed.
Migraine is a common neurological disorder affecting approximately 18% of women and 6% of men. It can cause significant disability and is ranked as the 6th highest cause of disability worldwide by the Global Burden of Disease Study. The document discusses the epidemiology, pathophysiology, clinical presentation, diagnosis, and management of migraine. Treatment involves both acute and preventive approaches, with acute options including analgesics, triptans, and ergotamines. Preventive medications include beta-blockers, anticonvulsants, calcium channel blockers, and antidepressants.
Acute neuropathic pain - Stephan Schug - SSAI2017scanFOAM
A talk by Stephan Schug at the 2017 meeting of the Scandinavian Society of Anaestesiology and Intensive Care Medicine.
All of the conference content can be found here: https://scanfoam.org/ssai2017/
Developed in collaboration between scanFOAM, SSAI and SFAI.
Vns Therapy™ System For Weikong For Printcalaf0618
The document discusses VNS Therapy, a treatment for epilepsy patients who have difficulty controlling seizures through medications alone. It provides information on:
- How VNS Therapy works by electrically stimulating the vagus nerve to impact brain regions involved in seizure activity.
- Clinical evidence that VNS Therapy can significantly reduce seizure frequency in refractory epilepsy patients and improve quality of life factors like mood and alertness.
- Safety data showing the risks of VNS Therapy are low, with most side effects being mild and transient.
- High patient and clinician satisfaction rates with VNS Therapy as an effective alternative or addition to medications for difficult-to-treat epilepsy.
trigeminal neuralgia and its dental considerationsGulshan Raghani
Trigeminal neuralgia is a condition characterized by severe, stabbing, intermittent pains in the face that are triggered by mild stimuli like brushing teeth or talking. It is caused by compression or irritation of the trigeminal nerve by blood vessels. Diagnosis is based on the pain characteristics and location. Treatment involves medications to reduce nerve activity or surgeries like microvascular decompression to relieve nerve compression. Dental procedures require special care in patients with trigeminal neuralgia to avoid triggering pain flare ups.
Peripheral neuropathy is damage to peripheral nerves that can affect quality of life and treatment. It has many causes in oncology patients including chemotherapy drugs and is increasing as neurotoxic drugs are used and patients live longer. Peripheral neuropathy is diagnosed based on symptoms and physical exam findings and graded on severity. Prevention focuses on monitoring for neuropathy before each treatment and modifying treatment dose and schedule. Management includes patient education, pharmacologic interventions like antidepressants, and non-pharmacologic options though evidence is limited. Nurses play a key role through thorough assessment and education.
Pain and Modern Medicine, Stephanie Davies, Head of Service, Pain Medicine Un...ArthritisNT
The document discusses pain and modern medicine. It defines pain and chronic pain. It notes that chronic pain is common, affecting 20% of Australians and costing $34 billion per year. While scans cannot detect pain, medications only help reduce pain in 30-40% of cases. The document discusses how views of pain have changed from being tissue-based to involving brain and spinal cord patterns. It advocates addressing all pain inputs using a biopsychosocial approach.
1) Trigeminal neuralgia is a disorder characterized by severe, sporadic facial pain affecting one or more divisions of the trigeminal nerve. It is often triggered by mild stimulation of the face like brushing teeth.
2) Treatment options include medications like carbamazepine, surgery such as microvascular decompression to separate compressing blood vessels from the trigeminal nerve, and interventional procedures like glycerol rhizolysis or gamma knife radiosurgery.
3) The document discusses the classification, diagnosis, differential diagnosis, medical management, interventional treatments and surgical treatment of trigeminal neuralgia. It provides details on evaluation, pharmacological options and technical aspects of various surgical and interventional
This document discusses pain prevalence and treatment in cancer patients. It finds that:
1. Pain affects 33-59% of patients after curative cancer treatment and 64-70% of patients with advanced or terminal cancer.
2. Cancer is the cause of 77-80% of pain in these patients, often due to bone metastases or nerve damage from the cancer or its treatment.
3. The WHO analgesic ladder recommends treating mild pain with non-opioids like acetaminophen, moderate pain with weak opioids like codeine, and severe pain with strong opioids like morphine. Adjuvant medications and interventional approaches may also help.
This document discusses pain prevalence and treatment in cancer patients. It finds that:
1. Pain affects 33-59% of patients after curative cancer treatment and 64-70% of patients with advanced or terminal cancer.
2. Cancer is the cause of 77-80% of pain in these patients, often due to bone metastases or nerve damage from the cancer or its treatment.
3. The WHO analgesic ladder recommends treating mild pain with non-opioids like acetaminophen, moderate pain with weak opioids like codeine, and severe pain with strong opioids like morphine. Adjuvant analgesics and interventional approaches may also help.
Multiple sclerosis: Medical and Nursing ManagementsReynel Dan
Multiple sclerosis (MS) is a chronic, progressive neurological disease involving demyelination of the central nervous system. It is characterized by exacerbations and remissions of symptoms that vary depending on the location of lesions in the brain and spinal cord. Common clinical manifestations include fatigue, weakness, sensory disturbances, and impaired coordination. While the exact cause is unknown, it is thought to involve an autoimmune response. Treatment focuses on managing relapses, reducing disease progression, and alleviating symptoms. Nursing care emphasizes education, rehabilitation, and supportive measures to help patients maintain optimal functioning.
Palliative care aims to improve quality of life for patients facing life-limiting illness and their families through pain and symptom management, psychosocial and spiritual support from diagnosis until end of life. It focuses on preventing and relieving suffering through early identification and treatment of pain, and addresses physical, psychosocial and spiritual problems. Palliative care is applicable alongside curative treatments and aims neither to hasten nor postpone death.
Sue Barnes - Pain management and Multiple SclerosisMS Trust
This document provides an overview of pain management for patients with multiple sclerosis (MS). It defines different types of pain commonly experienced by MS patients, such as Lhermitte's sign and central neuropathic dysaesthesia. Neuropathic pain is discussed in more detail, including its pathophysiology and diagnosis. Common neuropathic pain medications for MS are presented, including amitriptyline, gabapentin, pregabalin, and opioids. National guidelines for treating neuropathic pain in MS are summarized. Specialist referral is recommended for complex pain or when first-line treatments are ineffective.
Trigeminal neuralgia is sudden, severe facial pain. It's often described as a sharp shooting pain or like having an electric shock in the jaw, teeth or gums.
Trigeminal neuralgia
Contents
Overview
Symptoms
Causes
Diagnosis
Treatment
This document discusses acute pain management in the emergency department. It begins with an introduction noting that pain is the most common presenting symptom in emergency departments, with over 60% of patients experiencing pain. It then focuses on defining acute pain and providing an overview of the pathophysiology of acute pain. The document also discusses common barriers to pain management in emergency settings, dos and don'ts of pain treatment, and strategies to improve pain management in the emergency department. It provides recommendations from international health organizations on patients' right to pain relief.
This document provides information on diabetic neuropathy including:
1. It defines diabetic neuropathy as the presence of peripheral nerve dysfunction symptoms and/or signs in people with diabetes after excluding other causes.
2. It lists risk factors for developing diabetic neuropathy such as poor glycemic control, alcohol use, hypertension, smoking, and longer duration of diabetes.
3. It describes the pathogenesis of diabetic neuropathy including increased aldose reductase activity and non-enzymatic glycation of proteins.
Similar to Trigeminal neuralgia, facial pain in MS (20)
Think Cognition - Finding clarity in brain health and MS managementMS Trust
This document summarizes a presentation on cognition in multiple sclerosis (MS). It discusses:
- What cognition is and common areas affected in MS like processing speed, memory, and executive function.
- Factors that can affect cognition like fatigue, thoughts, and illness. Cognitive impairment is common in MS, ranging from 43-70% of patients, and usually progresses over time.
- The importance of assessing cognition through clinical interviews, observations, and formal testing to understand changes and their impact. Strategies are suggested to help patients cope with cognitive difficulties.
- Maintaining brain health through cognitive reserve, brain reserve, and lifestyle factors. Disease-modifying therapies may help reduce brain atrophy associated with
The document summarizes the agenda and activities of the TiMS (Therapists in Multiple Sclerosis) meeting from November 5th 2019. It discusses TiMS's work over the past 6 years in education, service development, research, and communication. It outlines past and future projects, including developing resources on respiratory health, ataxia, stretching techniques, and competencies. It also reviews a pilot study on monitoring respiratory function in people with MS and plans for future research. The meeting provided an overview of TiMS's accomplishments and goals to continue improving MS care through multi-disciplinary collaboration.
The document provides an update on the Specialist Nurse Programme (SNP) and Advanced MS Champion (AMSC) programme. It summarizes the outcomes from the first three SNP pilot sites, which showed reductions in caseloads, waiting times, and costs from avoided admissions. It also provides early learnings from AMSC sites, including potential cost savings. The programmes are demonstrating value through improved care coordination and access for people with MS.
This document provides information on managing ataxia in multiple sclerosis (MS) through a multidisciplinary rehabilitation approach. It discusses the importance of managing ataxia to minimize social isolation and maximize quality of life. Assessment involves evaluating multiple body systems that can contribute to ataxia in MS. Interventions discussed include exercises to challenge balance, activities to improve coordination, strategies to compensate for impairments, and considerations for mobility aids, posture, eating, and cooling techniques. Evidence is presented supporting long-term rehabilitation to maximize potential and slow deterioration.
Cerebellar ataxia is a common symptom in multiple sclerosis that can cause motor and cognitive signs. Cerebellar lesions and ataxia are associated with poorer prognosis. Symptoms vary depending on the location of lesions within the cerebellum and connections. While training programs have shown benefits for motor function in cerebellar degenerations, the effects of specific oculomotor training in MS are unclear. Recovery from cerebellar damage may occur through substitution within the cerebellum or recruitment of other brain areas through mechanisms like synaptic plasticity.
Vitamin D may have benefits for people with multiple sclerosis (MS). Low vitamin D levels are common in MS and are associated with worse bone health and increased disease activity. Supplementation to raise vitamin D levels has been shown to improve bone mineral density in MS. Some clinical trials also found signals that vitamin D supplementation may reduce MRI lesions and relapse rates. However, the evidence is mixed and high-dose supplementation over long periods may carry risks. Experts recommend MS patients aim to maintain vitamin D levels between 50-100 nM through supplementation as needed. More research is still needed to fully understand the role and optimal dosing of vitamin D in MS.
The document discusses postprandial hypersomnolence, also known as "food coma". It provides the physiological mechanisms that cause food-induced sleepiness, including increased levels of adenosine, parasympathetic activation, insulin and tryptophan levels, and insulin-induced hypokalemia. It then discusses an audit conducted at Barts-MS that found people with multiple sclerosis experience food coma more severely than others, with severity correlated to MS severity. People with MS reported making dietary changes and using caffeine to reduce symptoms.
Treatment of MS Symptoms during pregnancy and whilst breastfeedingMS Trust
This document summarizes key information from a presentation on managing multiple sclerosis during pregnancy. It discusses various drug treatments for MS symptoms like spasticity, pain, and mobility issues. It notes that clinical trials on drug safety during pregnancy are limited. Physiological changes in pregnancy can impact drug absorption and dosage requirements. Major birth defects may occur early in pregnancy before the pregnancy is recognized. The risks and benefits of continuing or adjusting treatments need to be considered. Gabapentin appears to have no contraindications, while drugs like duloxetine and carbamazepine require careful consideration during pregnancy. Non-drug options should also be explored. Close monitoring by an MS team is recommended for pregnant women with MS.
Managing pregnancy in MS – an update (Since 2016)MS Trust
Dr Peter Brex presented an update on managing pregnancy in multiple sclerosis (MS). The key points were:
1) It is important to provide pre-pregnancy counseling to understand medication management during pregnancy and establish links with local obstetric teams.
2) While there are no clinical trials of disease-modifying therapies (DMTs) in pregnancy, data from pregnancy registries can provide guidance on safety.
3) Recommended time periods for stopping various DMTs prior to conception range from 5 months to over 2 years depending on the medication.
Multiple Sclerosis and Sleep - A Different PerspectiveMS Trust
Neil Stanley is an independent sleep expert with over 37 years of experience in sleep research. He has worked at several research institutions and hospitals and is a member of several sleep societies. Sleep disorders in people with conditions like multiple sclerosis often remain underreported, underdiagnosed, and undertreated. A recent study found that 74% of MS patients studied had sleep disorders. Sleep plays an important role in the immune system, endocrine system, and brain function. Multiple sclerosis can cause or exacerbate existing sleep problems like insomnia, sleep apnea, and restless legs syndrome. Effective treatment of sleep disorders and underlying MS symptoms is important for managing pain, fatigue, mood, and daytime sleepiness in patients.
This document discusses cannabis and its potential uses and effects for people with multiple sclerosis (MS). It outlines that cannabis contains over 500 compounds including cannabidiol (CBD) and tetrahydrocannabinol (THC) which act on receptors throughout the body. While there is insufficient evidence that cannabis is disease-modifying for MS, some studies suggest it may provide symptomatic relief for issues like spasticity, pain, sleep difficulties, and bladder problems. The document acknowledges many MS patients use cannabis for self-management of symptoms but notes the need for more high-quality clinical trials to better understand efficacy and safety.
Dizziness and balance problems affect over 70% of people with multiple sclerosis. These issues are linked to reduced mobility and increased falls, and negatively impact quality of life. The vestibular system helps with gaze stability and postural control. In MS, vestibular deficits can cause impairments in these areas as well as dynamic balance and participation. Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo in MS and is treated with particle repositioning maneuvers. Vestibular rehabilitation aims to improve vestibular compensation through exercises targeting gaze stability, postural control, and motion tolerance.
MS and work - staying in work and leaving work wellMS Trust
This document discusses supporting people with multiple sclerosis (MS) in work and leaving work. It provides an overview of national policies promoting workforce participation for those with disabilities. Research shows work provides important benefits, but participation declines as MS progresses due to increasing symptoms. Early intervention is key to help manage symptoms and make workplace adjustments, while supporting eventual transitions out of work. Vocational rehabilitation should be personalized and address both medical and psychosocial factors.
This document summarizes a skills development workshop for MS nurses that aimed to help them manage challenges in their roles. The workshop covered: identifying challenges MS nurses face in consultations and managing time/admin duties; tips for effective consultations including communication skills, managing patient dependence, and ending consultations; ways to manage time including organization, delegation, and auditing services; and sources of ongoing learning, development, and support for MS nurses.
Blood Monitoring in an MS Disease Modifying Therapy ClinicMS Trust
This document discusses blood monitoring in an MS disease modifying therapy (DMT) clinic. It identifies blood monitoring as a "wicked problem" due to its complex, interconnected nature with no single solution. It discusses various challenges with blood monitoring including coordinating tests, communicating results, interpreting abnormalities, and ensuring accountability. The document also reviews concepts from human factors engineering that could help address issues, such as clear roles and communication, avoiding distractions, and managing fatigue and resources. It explores what an ideal blood monitoring system may look like.
A practical guide to stopping disease modifying therapyMS Trust
This document discusses guidelines for stopping disease-modifying therapies (DMTs) in multiple sclerosis (MS) patients. It notes that the decision to stop should consider factors like type of MS, disability level, duration of remission, and age. Older patients and those with longer remission periods are less likely to see returns of disease activity after stopping. It also warns that certain DMTs like natalizumab have higher risks of rebound disease activity. The document advocates discussing potential DMT stops before starting treatment and promoting education to help patients make informed decisions.
Considerations for pregnancy and the postnatal periodMS Trust
This document discusses considerations for pregnancy and the postnatal period, including common health issues, mental health risks, and domestic abuse. It outlines the standard number of healthcare professional contacts during and after pregnancy. It emphasizes the increased risks of depression, suicide, and domestic abuse during this period. It provides guidance on identifying and responding to mental health issues, domestic abuse, and vulnerable families. The document stresses vigilance, asking direct questions, and making referrals when needed to support maternal health and reduce mortality up to one year postpartum.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
This presentation gives information on the pharmacology of Prostaglandins, Thromboxanes and Leukotrienes i.e. Eicosanoids. Eicosanoids are signaling molecules derived from polyunsaturated fatty acids like arachidonic acid. They are involved in complex control over inflammation, immunity, and the central nervous system. Eicosanoids are synthesized through the enzymatic oxidation of fatty acids by cyclooxygenase and lipoxygenase enzymes. They have short half-lives and act locally through autocrine and paracrine signaling.
Discover the benefits of homeopathic medicine for irregular periods with our guide on 5 common remedies. Learn how these natural treatments can help regulate menstrual cycles and improve overall menstrual health.
Visit Us: https://drdeepikashomeopathy.com/service/irregular-periods-treatment/
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Travel Clinic Cardiff: Health Advice for International TravelersNX Healthcare
Travel Clinic Cardiff offers comprehensive travel health services, including vaccinations, travel advice, and preventive care for international travelers. Our expert team ensures you are well-prepared and protected for your journey, providing personalized consultations tailored to your destination. Conveniently located in Cardiff, we help you travel with confidence and peace of mind. Visit us: www.nxhealthcare.co.uk
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
The Children are very vulnerable to get affected with respiratory disease.
In our country, the respiratory Disease conditions are consider as major cause for mortality and Morbidity in Child.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
PGx Analysis in VarSeq: A User’s PerspectiveGolden Helix
Since our release of the PGx capabilities in VarSeq, we’ve had a few months to gather some insights from various use cases. Some users approach PGx workflows by means of array genotyping or what seems to be a growing trend of adding the star allele calling to the existing NGS pipeline for whole genome data. Luckily, both approaches are supported with the VarSeq software platform. The genotyping method being used will also dictate what the scope of the tertiary analysis will be. For example, are your PGx reports a standalone pipeline or would your lab’s goal be to handle a dual-purpose workflow and report on PGx + Diagnostic findings.
The purpose of this webcast is to:
Discuss and demonstrate the approaches with array and NGS genotyping methods for star allele calling to prep for downstream analysis.
Following genotyping, explore alternative tertiary workflow concepts in VarSeq to handle PGx reporting.
Moreover, we will include insights users will need to consider when validating their PGx workflow for all possible star alleles and options you have for automating your PGx analysis for large number of samples. Please join us for a session dedicated to the application of star allele genotyping and subsequent PGx workflows in our VarSeq software.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
2. Aims and Objectives
Differential diagnosis
Trigeminal neuralgia
Diagnosis
Investigations
Medical management
Surgical management
Epidemiology
Patho-physiology
3. Epidemiology TN
Incidence : 4.5 / 100,000
Prevalence : 0.001% - 0.3%
Peak incidence : 50-60 years
Multiple sclerosis (2- 4 % of TN
patients)
Hypertension
Stroke
Zakrzewska JM, Hamlyn PJ. In Epidemiology of
Pain. IASP, 1999
Mueller D et al Cephalagia 2011
Pan et al Cephalagia 2011
4. Changing epidemiology of TN?
Incidence
per 100,000
PY
Hall et al
2006
Dieleman
2008
Koopman et
al 2009
Number 8,268
322 118
Incidence 26.8
28.9 12.6
5. What are other causes of
unilateral episodic facial pain?
18. The Story of Pain
curiosity to ask “tell me about yourself”
patience to wait for the answer
Platt et al 2001
19. Stories
• patients tell stories to become who they are
• patient stories are addressed to someone
• the clinician must listen
• the quality of attention is important and
you " have to be caught up” – it is an act of
surrender
20. What are the features of
trigeminal neuralgia?
Misery by Rosa Sepple
21. Character of TN pain
The character of trigeminal neuralgia is very
distinctive and pts will use words such electric
shock, lightening – implies speed as well as severity
27. Trigeminal Neuralgia –IASP
“ a sudden, usually unilateral,
severe, brief, stabbing, recurrent
pain in the distribution of one or
more branches of the fifth cranial
nerve”.
29. Associated features
Loneliness – isolation – how can
you go to social activities when
you cannot eat,
how can you be intimate when
you cannot bear your face to be
touched
How do you get across the
message that despite looking
normal you have one of the most
suicide pain
Depression is common
Fear of a returning attack is
always with the patients and
psychologist will tell us that this
drives further pain
58. Novel Sodium Channel Blocker
CNV1014802 June 2014
• Treatment failure rate
33% CNV1014802 vs 65% placebo
• Decrease in pain severity
55% CNV1014802 vs 18% placebo
• Average reduction in number of paroxysms
60% CNV1014802 vs 12% placebo
59. Medications
There is a medicine
you can take
But it’s not the cure
It may make your
drowsy
It may make you sick
There are more pills
to take
And there’s no
miracle fix
72. How 302 patients with MS and TN
compare with 7982 TN only patients ?
Same age and demographics
More constant, bilateral pain
Use wider range of drugs
Undergo more ablative surgery
73. Why are there few TN Drug Trials ?
Diagnosis strictly clinical
Condition relatively rare
Medications may interfere with other drugs
Medications may take time to work
Spontaneous remission common
Side-effects may take time to appear
Pain very severe: justify using placebo