A Week in Review: Feb 5th-Feb 10th

Monday: Back to Basics Deep Dive: The Hand

Tuesday: An Alternative Abortive Therapy in Refractory Trigeminal Neuralgia Pain Crisis

  • Trigeminal Neuralgia is severe pain in the distribution of the trigeminal nerve distribution
  • Typical therapy is carbamazepine 200mg / day (upto 1200mg / day)
  • Second Line is gabapentin or Lamotrigine. Baclofen as an add-on for refractory causes
  • There are multiple cases reports for severe refractory exacerbations suggesting IV phenytoin or fosphenytoin for abortive therapy

Thursday: #emconf: Hand Injury Pearls

  •  High pressure Injection injuries always require surgical consult & exploration
  •  You can use a tourniquet for up to 2 Hours
  • OK to use Lido with EPI in digits as long as no concern for vascular injury

Friday: A Tale of Baclofen Toxicity

  •  Symptoms = Range of CNS depression to delirium to paradoxical seizures to coma
  •  May have: fixed, dilated pupils, loss of brainstem reflexes
  •  Symptoms can last up to 7 days, Avoid early declarations of brain death