Lifelong antiplatelet therapy is recommended after PFO closure. PFO closure is recommended if there is no other reason for the stroke was found in patients with PFO.

Myasthenia gravis RX

Quick list of myasthenia gravis medications

MG Rx : Myasthenia gravis med list 🟪Cholinesterase inhibitors : Pyridostigmine (Mestinon) 🟪 Corticosteroids: Prednisone 🟪Immunosuppressants: Inc infection, …

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Trigeminal neuralgia

Trigeminal neuralgia

Trigeminal neuralgia
👉 > 50. F > M.
👉 5th CN : facial sensory / motor
👉Trigeminal neuralgia: Sudden,severe stabbing/ jabbing / lancinating / electric shock like pain,
👉2, 3rd div, Unilateral, lasting seconds to few minutes. Multiple episodes lasting for hours.
👉Aggravated by any touch, cold wind draft, jaw movement.
👉 Causes: 80% SCA superior cerebellar a wrapped around the nerve exiting the brain stem. Others : Dental abscess, TMJ, strokes, multiple sclerosis, trauma, tumor, AV malformation, Temporal arthritis, post herpetic neuralgia, glossopharyngeal neuralgia.
Meds: carbamazepine, ox carbamazepine, Baclofen, Lamotrigine, Phenytoin, gabapentin, Pregablin, amitriptyline, Pimozide, Clonazepine, Lidocaine, Duloxetine,
✂️Surgical option if meds failed:
👉Microvascular decompression : 75% effective, complicated with facial numbness. Prevents further myelin sheath damage.
👉Radiofrequency thermocoagulation Rhizotomy: damage the nerve. No GA gen anesthesia needed.
👉Steriotactic radiosurgery: focal radiation therapy. No GA needed.
👉Percutaneous needle / catheter : damaging area where nerve branches. Done in elderly, poor surgical candidate.
👉Baloon compression: inflating damaging the nerve.
👉Glycerol injection.



🔲 1 out of 4
🟨 Hyperesthesia / Allodynia
🟨 Vasomotor: Temperature / skin color asymmetric changes
🟨 Sudomotor: asymmetric edema/ sweating changes
🟨 Motor / trophic changes: weakness, dystonia, tremors / skin, hair, nail
🔲 Involve distal part of limbs but not head / trunk
🔲 Does not involve particular nerve or nerve root
🔲 Triple phase bone scan showing ipsilaterally active bone resorption within 5 months. Compare both sides! increased localized biphosphonate tracer uptake. Diffuse joint involvement r/o inf / arthralgias)