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Trigeminal Neuralgia (TN) 三叉神经痛


Trigeminal Neuralgia (TN) is a facial disorder described as one-sided, spasmodic stabbing, and recurrent pain found in the one or more of the sensory branches located near the fifth cranial nerve. This is one of the most common diseases associated with cranial nerves and one of the most often diagnosed facial pain complications (Sabalys, Juodzbalys, & Wang, 2012).

TN can be a very debilitating disorder as the painful experience can last anywhere from a few seconds to many minutes, and the episodic pain may occur a few times a day or can manifest hundreds of times in a 24-hour time frame (Zakrzewska & Linskey, 2014). The pain associated with trigeminal neuralgia may not always be constant due to this disease process is known for having periods of remission that can last for several months or even a year (Sabalys, Juodzbalys, & Wang, 2012). However, the pain does return after some time without treatment.

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Parkinson Disease 帕金森病 (Reading & Sharing)

Parkinson’s Disease (PD) is a chronic degenerative disease of the nigrostriatal pathway that affects the dopamine producing neurons in the brain which cause an imbalance and impairment motor function that led to its name as a Shaking Palsy Disease when it was discovered in the 1800’s by Dr. Parkinson (Braun et al, 2017). The pathophysiology of PD shows a reduction of dopamine in the corpus striatum of the brain which upsets the normal balance between the inhibitory dopamine and excitatory acetylcholine neurotransmitters. This prevents the affected brain cells from performing their normal inhibitory function within the CNS and causes most of the parkinsonian symptoms which appears as characterized by tremor, bradykinesia, rigidity, and postural instability (Ekman et al ,2013):

  • Resting tremor, may be worse on one side of the body affecting the limbs and sometimes involves the head, neck, face, and jaw
  • Bradykinesia is slowness of movement, loss of spontaneous movement, and delay in initiating movement; and akinesia which is absence or poverty of normal movement
  • Rigidity in performance of all movements, and increased during movement.
  • Mask like facies secondary to rigidity and drooling.
  • Postural abnormalities: head bent forward, stooped posture, loss of postural reflexes
  • And other manifestations such as poor balance, autonomic disorders, depression, gait difficulties, verbal fluency impaired, and etc.

The above clinical manifestations could lead to complications such as injury from 1) Falls, 2) Food Aspiration due to impaired swallowing, 3) Urinary Tract Infections, and 4) Skin breakdown due to increased immobility. It is therefore of prime importance to measure the patient’s quality of life since PD is a debilitating disease and patient’s emotional and social well being are affected by its physical symptoms.

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​Generalized Anxiety Disorder (GAD)

Prevalence of GAD

​Generalized Anxiety Disorder (GAD) is one of the most common mental illness in the United States encountered by primary care physicians (ER, 2015). Anxiety may be normal in day to day life because people may worry about things like health, family, money, work, and other things. However, individuals with GAD may feel worried excessively or feel nervous about certain things even if there is no reason to (ER, 2015). People with GAD often find it difficult to control their anxiety and stay focused on daily tasks. Despite all these, GAD can still be treated.

​The 12-month prevalence for GAD is 3.1% of US adult population according to the National Institute of Mental Health (NIH, 2018). Again 3.5% of these cases are classified as severe, however, no data is reported on gender distribution of the condition. 12-month Healthcare Use is 43.2% of the patients with the disorder, and 43.7% of those receiving treatment receives less adequate treatment, and this represents 18.9% of those with the disorder (NIH, 2018).

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Rheumatoid Arthritis (RA) 类风湿性关节炎

The definition of Rheumatoid arthritis (RA) is a systemic auto-immune disease characterized by inflammatory polyarthritis which affects peripheral joints, especially the small joints of the hands and feet. This is a chronic and progressive disease in which if the process of inflammation is untreated may lead to cartilage and bone erosions and joint destruction (Ferri, 2018, p. 1125).

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Anxiety / Reading and Sharing

Anxiety can be normal from time to time, but excessive ongoing anxiety and worry that someone might have difficulty in controlling and interfere with day-to-day activities may be a sign of generalized anxiety disorder (Mayo Clinic Staff, 2018, p. 1). This disease is a chronic condition with exacerbations and suicide risk is higher than in the general population.

 

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