Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Cause | Diagnostic Tests | Management |
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Trigeminal Neuralgia |
- Clinical diagnosis based on characteristic sharp, stabbing pain along the distribution of the trigeminal nerve
- MRI: To rule out structural causes (tumours, multiple sclerosis) |
- Carbamazepine: First-line treatment
- Gabapentin or baclofen: For pain relief - Surgical intervention: Microvascular decompression or nerve ablation for refractory cases |
Sinusitis |
- Clinical diagnosis:facial pressure, nasal congestion, purulent nasal discharge
- CT scan: To assess sinus involvement in chronic or recurrent cases - Nasal endoscopy: In cases of chronic sinusitis |
- Decongestants: To reduce nasal congestion
- Antibiotics: For bacterial sinusitis - Saline irrigation: To flush sinuses - Surgery: Functional endoscopic sinus surgery (FESS) in chronic cases |
Temporomandibular Joint (TMJ) Disorder |
- Clinical diagnosis based on jaw pain, clicking, or locking
- Jaw X-ray or MRI: To evaluate joint and surrounding structures |
- NSAIDs: For pain relief
- Mouth guards: To reduce clenching and grinding - Physical therapy: Jaw exercises to improve function - Surgery: In severe cases, for joint repair or replacement |
Cluster Headache |
- Clinical diagnosis based on characteristic excruciating unilateral facial pain, typically around the eye
- CT or MRI: To rule out structural causes |
- Oxygen therapy: 100% oxygen at onset
- Triptans: For acute attacks (e.g., sumatriptan) - Verapamil: For prevention in chronic cases |
Dental Abscess |
- Clinical diagnosis based on localized tooth or gum pain, swelling, and fever
- Dental X-ray: To assess for abscess or tooth decay |
- Antibiotics: For infection control (e.g., amoxicillin)
- Drainage or root canal: To remove the abscess - Tooth extraction: In severe or untreatable cases |
Shingles (Herpes Zoster) |
- Clinical diagnosis based on painful vesicular rash along the facial nerve (typically unilateral)
- Viral PCR or culture: For confirmation in atypical cases |
- Antivirals: Acyclovir or valacyclovir
- Pain management: NSAIDs, gabapentin for postherpetic neuralgia - Shingles vaccine: To prevent recurrence |
Giant Cell Arteritis (Temporal Arteritis) |
- Clinical diagnosis based on scalp tenderness, jaw claudication, and visual symptoms
- Temporal artery biopsy: Gold standard for diagnosis - USS looking for "haloes": Newer diagnostic - Erythrocyte sedimentation rate (ESR): Elevated in inflammation |
- Corticosteroids: High-dose prednisone to prevent vision loss
- Aspirin: To reduce the risk of ischaemic complications - Regular monitoring: For side effects of long-term steroid use |
Glossopharyngeal Neuralgia |
- Clinical diagnosis based on episodes of severe pain in the throat, tonsils, and base of the tongue
- MRI: To rule out compressive lesions |
- Carbamazepine or gabapentin: For pain control
- Surgical intervention: Microvascular decompression for refractory cases |
Migraine |
- Clinical diagnosis based on recurrent episodes of pulsating, unilateral headache with associated nausea, photophobia, or aura
- MRI: To rule out secondary causes if atypical presentation |
- Triptans: For acute attacks
- NSAIDs: For pain relief - Preventive therapy: Beta-blockers or anticonvulsants for frequent migraines |
Sinus Tumour |
- CT or MRI: To visualize the mass and extent of the tumour
- Biopsy: To confirm malignancy |
- Surgical resection: Removal of the tumour
- Radiation/chemotherapy: Depending on the type and stage of the tumour - Follow-up imaging: To monitor for recurrence |