Neurological Disorders that Impact Dentistry

Comprehensive vocabulary flashcards reviewing core neurological disorders, headache classifications, cranial nerve palsies, stroke protocols, neurodegenerative diseases, neuropathies, and syncope management relevant to clinical dentistry.

Trigeminal Neuralgia

A chronic neuropathic pain condition characterized by recurrent paroxysmal ipsilateral facial pain along branches of cranial nerve V ($\text{CN V}$), presenting as severe, sharp, electric shock-like or stabbing pain lasting from seconds to $2\text{ minutes}$, triggered by light touch, chewing, talking, or cold wind.

First-Line Medical Treatment for Trigeminal Neuralgia

Carbamazepine or Oxcarbazepine.

Bell's Palsy

An acute peripheral palsy of the facial nerve ($\text{CN VII}$) causing lower motor neuron weakness of the entire ipsilateral half of the face muscles, resulting in a smooth forehead, dropped mouth angle, inability to close the eye, painful or irritative hearing, and diminished taste over the anterior two-thirds of the tongue.

Bell's Palsy Medical and Supportive Therapy

Medical treatment consists of oral corticosteroids (Prednisolone within $72\text{ hours}$), and supportive therapy includes eye protection such as lubricating drops and night patching.

Migraine

A primary neurovascular headache disorder resulting from genetic and neurological factors that make the brain oversensitive to environmental and physiological changes, characterized by recurrent moderate-to-severe unilateral pulsating or throbbing head pain aggravated by activity and associated with nausea, photophobia, phonophobia, and an aura.

Cluster Headache

A headache disorder involving trigeminal, autonomic, and blood vessel inflammation, presenting with sharp, non-throbbing unilateral orbital pain accompanied by autonomic signs such as lacrimation, rhinorrhea, miosis, ptosis, and restlessness.

Acute Management of Cluster Headache

$100\%$ Oxygen and subcutaneous Sumatriptan (a serotonin agonist).

Tension-Type Headache

The most common primary headache disorder, involving peri-cranial muscle tenderness and central pain processing, characterized by a dull, pressing, band-like bilateral pain of mild-to-moderate intensity that does not worsen with routine physical activity and lacks nausea or vomiting.

Seizure

A single, temporary event of abnormal electrical activity in the brain.

Epilepsy

A chronic neurological disorder characterized by a tendency for recurrent, unprovoked seizures.

Drug-Induced Gingival Hyperplasia

A fibrotic, non-hemorrhagic, painless lobulated gingival overgrowth originating at the interdental papillae that primarily affects the anterior maxillary and mandibular buccal segments, commonly caused by the anticonvulsant Phenytoin.

Status Epilepticus

A medical emergency defined by a seizure lasting longer than $5\text{ minutes}$ ($> 5\text{ minutes}$) or repeated seizures occurring without recovery of consciousness between episodes, requiring immediate activation of Emergency Medical Services ($\text{EMS}$).

Transient Ischemic Attack (TIA)

A transient episode of neurological dysfunction caused by focal brain or spinal cord ischemia without acute infarction, usually resolving within $24\text{ hours}$.

Stroke (Cerebrovascular Accident - CVA)

Rapidly developing clinical signs of focal or global disturbance of cerebral function of vascular origin lasting longer than $24\text{ hours}$ ($> 24\text{ hours}$) or leading to death ($85\%$ ischemic, $15\%$ hemorrhagic), typically manifesting deficits on the contralateral side of the body.

FAST Protocol

An emergency screening assessment for stroke comprising: Face (unilateral facial droop or asymmetry when smiling), Arms (unilateral arm drift when raised), Speech (slurred, garbled, or absent speech), and Time (call EMS immediately).

Parkinson's Disease

A progressive neurodegenerative disorder marked by the loss of dopaminergic neurons in the substantia nigra, clinically characterized by resting tremor ("pill-rolling"), bradykinesia, muscle rigidity, postural instability, mask-like facies, and sialorrhea.

Alzheimer's Disease

A progressive neurodegenerative disease characterized by cerebral cortical atrophy, clinically presenting with memory loss, cognitive decline, disorientation, apraxia, impaired judgment, behavioral changes, and poor oral hygiene.

Apraxia

The loss of the ability to execute a previously known or learned movement or experience, despite having the motor ability and desire to perform it.

Diabetic Peripheral Neuropathy

A disorder caused by chronic hyperglycemia-induced microvascular damage and metabolic stress, presenting with symmetrical sensory loss in a "glove-and-stocking" distribution, paresthesia, and burning pain.

Diabetic Autonomic Neuropathy

Destruction of autonomic nerves controlling involuntary processes, presenting with orthostatic hypotension (inhibition of compensatory baroreceptor reflex responses during rapid postural changes), altered sweating, resting tachycardia, and neurogenic bladder.

Syncope

A transient, self-limiting loss of consciousness and postural tone caused by temporary global cerebral hypoperfusion, characterized by rapid onset, short duration, and spontaneous complete recovery.

Vasovagal Syncope (Neurocardiogenic)

A temporary loss of consciousness caused by excessive hyper-parasympathetic tone leading to bradycardia and systemic vasodilation, often preceded by prodromal pale skin, diaphoresis, and nausea, with rapid recovery when placed flat.

Orthostatic Hypotension

A drop in blood pressure upon moving upright caused by failure of the autonomic vasoconstrictor reflex, occurring in the absence of an emotional trigger.

Local Anesthetic Toxicity (LAST)

Central nervous system toxicity caused by accidental intravascular injection, clinically presenting with initial excitatory signs (metallic taste, tinnitus, muscle twitching) followed by CNS depression or seizures.

Trendelenburg Position

A supine posture with the patient's legs elevated $10\text{--}15^{\circ}$, used as the primary positioning intervention during acute syncope to restore cerebral perfusion.