Diseases of peripheral nervous system

Question 1

What is ddx, hx, PE and Ix for CNS lesions, peripheral nerves, NMJ disorders and muscle diseases?

Answer 1

Question 2

Define radiculopathy, plexopathy and neuropathy (mononeuropathy, mononeuritis multiplex, polyneuropathy)

Answer 2

□ Radiculopathy involving nerve roots
□ Plexopathy involving nerve plexus
□ Neuropathy involving nerves
→ Mononeuropathy: only one nerve affected
→ Mononeuritis multiplex: multiple sequential mononeuropathies
→ Polyneuropathy: symmetrical involvement of all/most peripheral nerves

Question 3

How to classify diseases of the peripheral nerves?

Answer 3

Question 4

What are the clinical features of diseases of the peripheral nerves?

Answer 4

Question 5

What are the mechanisms of mononeuropathy?

Answer 5

□ Entrapment: damage to a nerve where it passes through a tight space
□ Trauma
□ Other focal lesions, eg. granulomatous inflammation

Question 6

What are the causes of entrapment mononeuropathy?

Answer 6

Question 7

What are the causes of mononeuritis multiplex?

Answer 7

Question 8

What are the causes of polyneuropathy?

Answer 8

Question 9

What are causes of acute and chronic axonal disease and what are there clinical features?

Answer 9

Question 10

What are causes of acute and chronic demyelinating disease and what are there clinical features?

Answer 10

Question 11

What are SS of polyneuropathy?
How to dx according to pattern of SS?

Answer 11

Question 12

What ddx consideration for polyneuropathy?
What is the workup and Ix done?

Answer 12

Question 13

What is disease modifying Tx and symptomatic Tx for polyneuropathy?

Answer 13

133 Antiganglioside antibodies (incl. anti-GQ1B, anti-GD3, anti-GM1) are associated with certain forms of GBS.
134 Anti-myelin associated glycoprotein antibodies are found in a rare form of CIDP-like polyneuropathy.
135 Anti-Hu and anti-Yo antibodies are often found in paraneoplastic neuropathies.

Question 14

What is classical presentation of GBS?
What is associated disease?
What are the types?

Answer 14

Question 15

What are the clinical features and SS of GBS?

Answer 15

Question 16

What are the Ix done for GBS?

Answer 16

Question 17

What is the Mx of GBS?
What is the prognosis?

Answer 17

Question 18

What are SS of Miller Fisher syndrome?
What Ix?
What ddx?
What Mx?

Answer 18

Question 19

What is the clinical features of CIDP?
What Ix done?

Answer 19

Question 20

What is the ddx and Mx for CIDP?

Answer 20

Question 21

What are causes and examples of hereditary motor and sensory neuropathy?

Answer 21

Causes: genetics (mostly autosomal dominant), pathology: demyelinating, hypomyelination or axonal degenerative
Ex: Charcot Mariet Tooth disease (CMTD), hereditary neuropathy with liability to pressure palsies (HNPP)

Question 22

When is onset of Charcot Marie Tooth disease?
What is etiology?
What are SS?
What is the Ix done?

Answer 22

Question 23

What kind of neuropathy is spinal muscular atrophy?
What gene association?
What is the classification type?
What are SS?
What is the Ix done to make dx?
What is Mx?

Answer 23

Question 24

What is affected in motor neuron disease? Its pathology?
What are the variants?

Answer 24

Question 25

What are causes of mixed UMN/LMN lesion?

Answer 25

Question 26

What is the clinical presentation of motor neuron disease?

Answer 26

Question 27

What is the PE, Ix and Mx for motor neuron disease?

Answer 27

Question 28

What are the causes of toxic neuropathies?
What are the clinical features?

Answer 28

Question 29

What is cause of MG?
What associated conditions?
What are the types of MG?

Answer 29

Question 30

What are the clinical features of MG?
What are characteristic signs of MG?

Answer 30

Question 31

What are the Ix done for MG?

Answer 31

Question 32

What is the ddx for ocular MG and generalized MG?

Answer 32

Question 33

What is the Mx for MG?

Answer 33

Question 34

What is the approach to management of acute exacerbation of MG i.e. myasthenic crisis and cholinergic crisis?

Answer 34

Question 35

Apart from MG what other myasthenic syndromes are there?
What is the SS, dx and Tx?

Answer 35

Question 36

What are the inherited and acquired causes of muscles?

Answer 36

Question 37

What are the clinical features of muscle diseases?
What are the Ix done?

Answer 37

Question 38

What is the classification of muscular dystrophy?

Answer 38

Question 39

What is the cause of X linked dystrophinopathies?
What is SS?
What is Mx?

Answer 39

Question 40

What is cause of myotonia?
What are features?
What is clinical test?

Answer 40

Question 41

What is the cause of myotonic dystrophy?
What are SS?
What is dx?
What is Mx?

Answer 41

Question 42

What are the ion chanellopathies that can mainfest as myotonic syndromes?

Answer 42

Question 43

What is the pathogenesis of periodic paralysis?
What is it characterized by?
What are the subtypes

Answer 43

Question 44

What is the etiology of malignant hyperthermia?
What are the clinical features?
What Ix?
What is Mx?

Answer 44

Question 45

What are the main types of inflammatory myopathies?

Answer 45

□ Dermatomyositis (DM)
□ Polymyositis (PM)
□ Inclusion body myositis (IBM)
□ Autoimmune necrotizing myopathy (AINM)
□ Overlap myositis (when a/w collagen vascular disease)

Question 46

What are the SS of inflammatory myopathies?
Adult form a/w malignancy

Answer 46

Question 47

What is the pathology, clinical course and SS of polymyositis vs dermatomyositis?

Answer 47

Question 48

What is the Ix done for inflammatory myopathy?
How to make a dx?
What is the Mx?

Answer 48

Question 49

What is the etiology of rhabdomyolysis?

Answer 49

Question 50

What are clinical features of rhabdomyolysis?
What are the Ix?
What is the Mx?

Answer 50

Question 51

What are the indications for thymectomy in myasthenia gravis?

Answer 51