Ebook Trigeminal nerve injuries: Part 2
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Ebook Trigeminal nerve injuries: Part 2
Clinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2ment of an accurate diagnosis, and the diagnosis is based upon a thorough evaluation of the patient's condition. The patient with a peripheral trigeminal nerve injuryR.A. Meyer. DDS. MS. MD. FACS(H) Georgia Oral and Facial Surgery, 1880 West Oak Parkway. Suite 215.Marietta. GA 30062, USADivision of Ebook Trigeminal nerve injuries: Part 2Oral and Maxillofacial Surgery. Department of Surgery. Northside Hospital. Atlanta. GA. USADepartment of Oral and Maxillofacial Surgery. Georgia HealtEbook Trigeminal nerve injuries: Part 2
h Sciences University.Augusta. GA. USAMaxillofacial Consultants. Ltd..1021 Holt’s Ferry. Greensboro. GA 30642. USA e-mail: rameyerC^aol.coms.c. BagherClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2Department of Surgery. Northside Hospital. Atlanta. GA. USAEastern Surgical Associates and Consultants. 2795 Peachtree Rd. Suite 2008. Atlanta.GA 30303. USADepartment of Oral and Maxillofacial Surgery. Georgia Health Sciences University.Augusta. GA. USADivision of Oral and Maxillofacial Surgery. Dep Ebook Trigeminal nerve injuries: Part 2artment of Surgery. Emory University. Atlanta. GA. USAe-mail: sbaghertirhotmail.commay present with a myriad of symptoms, often not conforming to a stEbook Trigeminal nerve injuries: Part 2
ereotypical pattern. Likewise, the responses to a neurological examination are varied and require interpretation based upon the knowledge and experienClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2any competent practitioner, whether a specialist in nerve injuries or not. The obtainment of a proper history and completion of an essential neurosensory examination will lead to the establishment of a diagnosis regarding the extent of the sensory neurological deficit and the classification of the n Ebook Trigeminal nerve injuries: Part 2erve injury'. Such an undertaking will allow the clinician to consider appropriate and timely treatment, and it should be a rewarding, rather than a cEbook Trigeminal nerve injuries: Part 2
onfounding, experience, if the clinician follows the information presented in this chapter on clinical evaluation of nerve injuries.10.1IntroductionToClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2ient with a sensory nerve injury is usually complaining of lost or altered sensation, pain, or a combination of both. Such symptoms are relatively difficult to quantify objectively by conventional means of physical examination, such as that of inspection, palpation, percussion, and auscultation. Man Ebook Trigeminal nerve injuries: Part 2y advanced, sophisticated, andM. Mi loro (cd.). Trigeminal Nerve Injuries,DOI 10.1 OO7/978-3-642-35539-4_ 10. © springer-Verlag Berlin Heidelberg 2013Ebook Trigeminal nerve injuries: Part 2
167168R.A. Meyer and s.c. Bagheritechnologically involved methods for peripheral nerve evaluation that utilize specialized testing equipment (such as Clinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2used primarily in laboratory' and clinical research studies 112. 35. 40. 46. 56. 65J. Such armamentarium is not necessary in order to conduct an accurate and reproducible clinical examination of the nerve-injured patient. However, the interested clinician is encouraged to peruse the references liste Ebook Trigeminal nerve injuries: Part 2d in the references. In this chapter, a practical, straightforward method for evaluating sensory nerve injuries that is used in clinical practice is pEbook Trigeminal nerve injuries: Part 2
resented [22. 43. 47. 70Ị. This evaluation is well within the capability of any clinician, whether a specialist in nerve injuries or not.Although the Clinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2tigators |65[. the information obtained from (he methods described in this chapter is valid, is reproducible by other examiners, and is routinely used in the diagnosis, classification, and treatment of peripheral nene injuries in all surgical specialties 17. 49]. A standardized method for peripheral Ebook Trigeminal nerve injuries: Part 2 nerve injury evaluation makes it possible to compare and interpret data from multiple treatment centers, thus enhancing the validity of clinical reseEbook Trigeminal nerve injuries: Part 2
arch and uniformity in terminology and nomenclature [39].When evaluating a patient with a sensory nene injury of the mouth or face, the clinician’s miClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2ies of diagnostic maneuvers that will accurately outline the area of sensory deficit, quantify as best as possible the magnitude and character of the deficit, and record this information in an objective format so that it can be a basis for comparison with subsequent examinations by the same clinicia Ebook Trigeminal nerve injuries: Part 2n or others, as needed. Accurate, legible, and complete records of this evaluation are indispensable since they are needed in making decisions regardiEbook Trigeminal nerve injuries: Part 2
ng treatment of the nerve injury. Complete medical records are imperativein retrospective studies of patient care, and they may be crucial in cases ofClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2s include the chief complaint: the history of present illness related to the chief complaint: a general head, neck, and oral examination: clinical neurosen-sory testing: imaging studies: and diagnosis and classification of the injury. Each of these subjects is addressed sequentially in this chapter. Ebook Trigeminal nerve injuries: Part 210.2HistoryThe patient history' begins with the patient’s chief complaint or the reason that the patient is seeking treatment. In the case of a sensorEbook Trigeminal nerve injuries: Part 2
y nerve injury, such as that of one of the peripheral branches of the trigeminal nerve, it will usually concern decreased altered sensation (paresthesClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2a separate neuro-sensory examination for each scenario (see below. Sect. 10.5.2). Some patients complain of both paresthesia and dysesthesia, so both types of examination may apply to these individuals. Patients often are frustrated or have difficulty in describing their sensory symptoms [45]. The e Ebook Trigeminal nerve injuries: Part 2xact nature of their complaints is often better determined by having the patient complete a preprinted questionnaire before being examined by the clinEbook Trigeminal nerve injuries: Part 2
ician. An example of the “nerve injury history” used in clinical practice and included in Appendix 10.A. I is referred to in the following discussion.Clinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishm Ebook Trigeminal nerve injuries: Part 2emands clarification in order to be meaningful in a clinical sense. The patient who complains of numbness may be attempting to describe altered sensation that falls any where along a continuum from minimal sensory deficit (hypo-esthesia) to total loss of sensation (anesthesia). There may be some com Ebook Trigeminal nerve injuries: Part 2ponent of pain (dysesthesia) as well. To assist the patient in verbally characterizing the nature of the sensory dysfunction.Clinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishmClinical Evaluation of Nerve Injuries10Roger A. Meyer and Shahrokh c. BagheriThe foundation of proper treatment of any medical condition is establishmGọi ngay
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