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Left Sided Hemifacial Spasm on Physical Exam

Typically treated with botulinum toxin (Botox)

#Hemifacial #Spasm #PhysicalExam #clinical #video
Sided Hemifacial Spasm ... #Hemifacial #Spasm
Management of Jackhammer Esophagus or Esophageal Spasm
Step 1: Assess the severity of the motility disturbance
Step 2:
or Esophageal Spasm ... Consider further diagnostics ... Esophagus #Esophageal #Spasm
Infantile Spasms 
Associated with Tuberous Sclerosis 
1) Flexor spasms: Sudden flexion of neck, trunk, arms, and
Infantile Spasms ... Sclerosis 1) Flexor spasms ... 2) Extensor spasms ... flexor-extensor spasms ... year of age • Spasms
Stiff Person Syndrome (SPS) - Diagnosis and Management Summary

Epidemiology:
 • Prevalence: 1-2 cases per million -
Syndrome (SPS) - Diagnosis ... stiffness, rigidity, spasm ... emotional upset • Spasms ... death - diaphragm spasm ... of superimposed spasms
Hydrophobia on Physical Examination

Seen in the late stages of rabies.  Caused by painful paroxysmal contractions
contractions and spasms
Vasospastic (Prinzmetal) Angina
Definition / Epidemiology:
 • Rest angina attributed to coronary artery vasospasm.
 • Patients often
Pathophysiology: • Diffuse spasm ... may precipitate spasm ... troponin elevation Diagnosis ... Angina #cardiology #diagnosis
Chicago Classification of Esophageal Motility Disorders
Achalasia
EGJ Outflow Obstruction
Distal Esophageal Spasm
Jackhammer Esophagus
Absent Contractility
Ineffective Motility
Rapid Contraction

#Chicago #Classification #Esophageal
Distal Esophageal Spasm
Dysphagia - Differential Diagnosis Algorithm
Oropharyngeal - Can't initiate swallow, Cough/nasal regurg when attempting to swallow
Esophageal
- Differential Diagnosis ... Diffuse Esophageal Spasm ... #Differential #Diagnosis
Chest Pain - Differential Diagnosis Framework

Cardiovascular Causes of Chest Pain:
 • Myocardium:
	- Myocarditis
	- CAD/ACS
	- Valvulopathy
	- Myopericarditis
- Differential Diagnosis ... Esophageal: - Spasm ... #Differential #Diagnosis
Dysphagia Differential Diagnosis Algorithm
Oropharyngeal Dysphagia
Structural
 • Tumors
 • Zenker's Diverticulum
 • Foreign Bodv
Neuromuscular Toxic/Metabolic
 • Myasthenia
Dysphagia Differential Diagnosis ... • Esophageal Spasm ... #Differential #Diagnosis