Similarities and Differences Between Two Similar Diseases

Similarities and Differences Between Two Similar Diseases

Similarities and Differences Between Two Similar Diseases 150 150 Peter

Similarities and Differences Between Two Similar Diseases

A comparison and contrast assignment’s focus is to identify and explore similarities and differences between two similar diseases. The goal of this exploration is to bring about a better understanding of both diseases.

You will research the two areas of content assigned to you and compare and contrast them in a discussion post. NOTE: A comparison and contrast assignment is not about listing the info regarding each disease separately but rather looking at each disease side by side and discussing the similarities and differences given the categories below. Consider how each patient would actually present to the office. Paint a picture of how that patient would look, act, what story they would tell. Consider how their history would affect their diagnosis, etc. Evaluation of mastery is focused on the student’s ability to demonstrate a specific understanding of how the diagnoses differ and relate to one another. Address the following topics below in your own words:

Presentation
Pathophysiology
Assessment
Diagnosis
Treatment

Compare and contrast the following diagnoses as assigned: Trigeminal Neuralgia and Giant Cell Arteritis

Sample Paper

NR 603 Wk 1 Disc

Trigeminal Neuralgia (TN) is a disorder that triggers painful feelings related to electric shock on one side of the face. In contrast, Giant Cell Arteritis (GCA) is an inflammation of the lining of an individual’s arteries. Both these conditions, in a way, compare and contrast in their processes (Thomas et al., 2021).

Presentation

Similarities

In both TN and GCA, presentation findings encompass an occurrence of development in individuals 50 years and older and a higher rate amongst women when compared to men. Also, detailed history and physical assessment are important when classifying TN of GCA. They both present with tenderness and pain of scalp, temporal and jaw region, headaches, and pain exacerbated by the movement.

Differences

Trigeminal neuralgia (TN) often impacts individuals over 50 years of age, although it can occur in younger adults too. TN can be inherited following malformation of blood vessels. Patients presenting to the office with TN usually report unplanned, strong episodic facial pain that lasts for a short time. Its pain is precise to maxillary, mandibular, and ophthalmic trigeminal nerve divisions. Pain is characterized by stabbing, burning, electric shocks, crushing, pressing, exploding, shooting, shock-like sensations, boring, migraine-like, and prickling. On the other hand, giant cell arteritis (GCA) is hardly diagnosed in individuals lesser than 50 years of age. Risk factors of GCA involve cerebrovascular disease, cardiovascular disease, peripheral vascular disease, hyperlipidemia, hypertension, and diabetes. Patients presenting with this condition usually report severe headache, jaw, scalp pain, limb or tongue claudication, and visual deficits.

Pathophysiology

Similarity

A key similarity between TN and GCA in their pathophysiology is that there are functional changes and processes accompanying them that eventually define the condition.

Differences

Pathophysiology of TN is unclear though it’s thought to be connected to chronic nerve compression of trigeminal nerve root occasioning into demyelination and advanced axonal degeneration in the small unmyelinated and finely myelinated fibers (Cazzato et al., 2020). Compression generally is triggered by the larger cerebellar artery of the trigeminal nerve roots in the pons. Unlike TN, GCA is interrelated to inflammation in the vascular system rather than demyelination. GCA encompasses inflammatory infiltrates of larger and middle-sized arteries with the occurrence of multinucleated giant cells between media and the intima layers and distraction of internal elastic lamina.

Assessment

Similarities

In both TN and GCA, severity is defined as serious. Physical examination in TN patients is typically unremarkable and valuable to pinpoint the underlying cause for the pain. Similar to TN, physical examination is usually general and essential to rule out the neoplasm, connective tissue illness, infection and other disorders. As well, providers assess both TN and GCA by collecting the symptoms present, medical history, and a detailed assessment aiming at neurological deficits.

Differences

Imaging tests such as MRI scans may be very useful in diagnosing TN to help check whether there’s pressure on the trigeminal nerve. When it comes to GCA, the assessment may involve taking small samples (biopsy) of the temporal artery. TN assessment also occurs in the ears, teeth, mouth, and temporomandibular joint (TMJ). In contrast, GCA assessment occurs in arteries situated close to the skin in front of the ears and continues up to scalp.

Diagnosis

Similarity

            Healthcare specialists can complete diagnoses in both conditions, such as physicians, physiotherapists, nurse practitioners, physician assistants, or healthcare scientists.

Difference

Diagnostic criteria for TN encompass 1) paroxysmal painful events including one or more branches of trigeminal nerve enduring for 1 second to 2 mins 2) pain described as intense, superficial, sharp, or knife-like 3) attacks different for every patient and are patient-specific, and lastly lack of clinically significant neurological deficit. Diagnostic criteria for GCA, on the other hand, include 1) 50 years or older at time of illness onset, 2) contained new-onset headache, 3) sensitivity or reduced pulse of the temporal artery 4) ESR larger than 50 mm/h, and lastly granulomatous segmental irritation in the temporal artery biopsy.

Treatment

Similarity

The similarity in these diseases is that both need different treatments that are essential to begin early for the best possible patient results.

Differences

The primary recommended treatment for TN is carbamazepine, as it has been proven effective. Other options include phenytoin, baclofen, lamotrigine, topiramate, gabapentin, pimozide, clonazepam, and valproic acid. In case pharmacologic management is not successful, surgical intervention can be indicated. Unlike treatment for TN, GCA encompasses higher doses of corticosteroids to reduce vascular inflammation (Schönau et al., 2021).

 

References

Cazzato, D., Maarbjerg, S., Bendtsen, L., & Lauria, G. (2020). Trigeminal Neuralgia: Channels, Pathophysiology, and Therapeutic Challenges. Cluster Headache and other Trigeminal Autonomic Cephalgias, 209-219. https://doi.org/10.1007/978-3-030-12438-0_16

Schönau, V., Roth, J., Tascilar, K., Corte, G., Manger, B., Rech, J., & Muratore, F. (2021). Resolution of vascular inflammation in patients with new-onset giant cell arteritis: data from the RIGA study. Rheumatology60(8), 3851-3861. https://doi.org/10.1093/rheumatology/keab332

Thomas, P., Kumar, A., Subir, A., McGeeney, B. E., Raje, M., Garg, D., & Castle10, K. (2021). Classification of Head, Neck, and Face Pains First Edition (WHS-MCH1): Position paper of the WHS Classification Committee. https://doi.org/10.52828/hmc.v1i1.classifications