[27] Polyneuropathy Flashcards

1
Q

What is polyneuropathy?

A

Damage or disease affecting peripheral nerves in roughly the same areas on both sides of the body

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2
Q

What are the features of polyneuropathy?

A
  • Weakness
  • Numbness
  • Burning pain
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3
Q

Where does polyneuropathy usually begin?

A

In the hands and feet

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4
Q

Where can polyneuropathy progress to from the hands and feet?

A
  • Arms and legs

- Sometimes other parts of the body

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5
Q

How many main patterns of polyneuropathy are there?

A

3

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6
Q

What are the 3 patterns of polyneuropathy?

A
  • Acute symmetrical peripheral neuropathy
  • Chronic symmetrical peripheral neuropathy
  • Multiple mononeuropathy
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7
Q

What can the causes of polyneuropathy be divided into?

A
  • Inherited causes

- Acquired causes

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8
Q

What are the inherited causes of polyneuropathy?

A
  • Charcot-Marie-Tooth disease

- HNPP

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9
Q

What are the acquired causes of polyneuropathy?

A
  • DM
  • Vascular neuropathy
  • Alcohol abuse
  • Vitamin B12 deficiency
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10
Q

What types of symptoms can patients with polyneuropathy experience?

A
  • Altered sensation
  • Pain
  • Weakenss
  • Autonomic symptoms
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11
Q

What part of the body is usually affected first in sensory polyneuropathy?

A

Feet

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12
Q

What are some features of sensory polyneuropathy?

A
  • Paraesthesia
  • Numbness
  • Burning pain
  • Loss of vibration sense and position sense
  • Muscle wasting
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13
Q

What are some symptoms of autonomic polyneuropathy?

A
  • Constipation
  • Loss of bowel and bladder control
  • Orhtostatic hypotension
  • Pale and dry skin with reduced sweating
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14
Q

What are some potential features seen in hereditary polyneuropathy?

A
  • Hammer toes
  • High arches
  • Scoliosis
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15
Q

What should be assessed when taking a history and examination of a patient with polyneuropathy?

A
  • Pattern of disease
  • If symptoms fluctuate
  • Deficits
  • Any pain
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16
Q

How is a diagnosis of polyneuropathy often made?

A

Clinically

17
Q

What investigations may be useful in diagnosing polyneuropathy?

A
  • Electrodiagnostic testing
  • Serum protein electrophoresis
  • Nerve conduction testing
  • Urinalysis
  • Serum CK
  • Antibody testing
18
Q

What are the differentials for polyneuropathy?

A
  • Toxins
  • Guillan-Barre Syndrome
  • Lyme disease
  • Hepatitis C
  • Amyloidosis
  • Acromegaly
  • Kidney failure
19
Q

What does management of polyneuropathy depend on?

A

Underlying cause

20
Q

What general management is advised in polyneuropathy?

A
  • Lose weight
  • Use a walking aid
  • Occupational therapy
21
Q

What are the potential complications of polyneuropathy?

A
  • Disability
  • Isolation
  • Loss of independence
  • Recurrent injuries
  • Permanent joint destruction
22
Q

What causes the recurrent joint injury and destruction in polyneuropathy?

A

Loss of sensation

23
Q

What is the joint destruction in polyneuropathy called?

A

Charcot joint