L5: Peripheral Neuropathy Flashcards
(71 cards)
1
Q
Anatomy of PNS
A
2
Q
Function of PNS
A
- Carry impulses to & from the CNS.
- These impulses regulate motor, sensory and autonomic activities.
2
Q
Def of Peripheral Neuropathy
A
- Neuropathy is an inflammation or degeneration of the peripheral and / or cranial nerves → impairment of conduction along these nerves → motor, sensory and / or autonomic manifestations.
3
Q
Classification of Peripheral Neuropathy
A
4
Q
Mononeuropathy
A
affection of & single nerve trunk in one limb
5
Q
Mononeuropathy Multiplex
A
affection at more than one nerve trunk in the same limb
6
Q
Polyneuropathy
A
affection of dore than one nerve trunk in more thair one limb
7
Q
Causes of Mononeurpathy & Mononeuropathy Multiplex
A
- Traumatic
- Infective
- Vascular
- Metabolic
8
Q
Causes of Mononeurpathy & Mononeuropathy Multiplex
- Traumatic
A
9
Q
Causes of Mononeurpathy & Mononeuropathy Multiplex
- Infective
A
- Leprosy
- Herpes Zoster
10
Q
Causes of Mononeurpathy & Mononeuropathy Multiplex
- Vascular
A
Polyarteritis Nodosa
11
Q
Causes of Mononeurpathy & Mononeuropathy Multiplex
- Metabolic
A
DM
12
Q
Causes of Polyneuropathy
A
- Heredofamilial
- Acquired
13
Q
Causes of Polyneuropathy
- Heredo-Familial
A
- Peroneal muscle atrophy.
- Hypertrophic interstitial polyneuropathy.
- Refsum disease.
14
Q
Causes of Polyneuropathy
- Acquired
A
15
Q
Acquired Causes of Polyneuropathy
- Infective
A
- Viral: mumps, measles.
- Bacterial: Typhus, Typhoid, Tetanus.
- Mycobacterial: Leprosy.
16
Q
Acquired Causes of Polyneuropathy
- Toxic
A
- Inorganic: lead, copper, arsenic, antimony, gold. (Heavy metals).
- Organic: alcohol, insecticides.
17
Q
Acquired Causes of Polyneuropathy
- Metabolic & Endocrine
A
Diabetes mellitus, uremia, amyloidosis, acromegaly, myxedema.
18
Q
Acquired Causes of Polyneuropathy
- Nutritional
A
Pellagra, Beri-Beri, subacute combined degeneration.
19
Q
Acquired Causes of Polyneuropathy
- Iatrogenic
A
Isoniazid, sulphonamides, phenytoin, vincristine.
20
Q
Acquired Causes of Polyneuropathy
- Autoimmune
A
Guillain Barre Syndrome, collagen vascular disorders.
21
Q
Acquired Causes of Polyneuropathy
- Paraneoplastic
A
Bronchogenic carcinoma, lymphoma.
22
Q
Pathology of Axonal Neuropathy
A
23
Q
Pathology of Demyelinating Neuropathy
A
24
CP of **Polyneuropathy**
- General
- Bilateral
- Symmetrical
- Distal more than Proximal
- Lower Limbs earlier than Upper Limbs.
25
CP of **Polyneuropathy**
- Sensory
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CP of **Polyneuropathy**
- Motor
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CP of **Polyneuropathy**
- Autonomic
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Investigations for **Polyneuropathy**
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Investigations for **Polyneuropathy**
- NCS
- Reduced nerve conduction velocity
30
Investigations for **Polyneuropathy**
- Nerve Bx
- usually the Sural Nerve
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Investigations for **Polyneuropathy**
- Detect the cause
- Blood sugar
- Tests for collagen vascular disorders
- S. creatinine
32
Types of **Diabetic Neuropathy**
- Diabetic Sensorimotor Polyneurtopathy
- Diabetic Autonomic Neuropathy
- Diabetic Proximal Neuropathy (Diabetic Amyotrophy)
- Diabetic Mononeuropathy
- Diabetic Truncal Neuropathy
33
**Diabetic Sensorimotor Polyneuropathy** is common in
Type I DM
34
CP of **Diabetic Sensorimotor Polyneuropathy**
35
Pathogenesis of **Diabetic Sensorimotor Polyneuropathy**
- Hyperglycemia will cause sorbitol accumulation → decreased myoinositol uptake by nerve Fibers ----> impaired impulse conduction.
36
CP of **Diabetic Autonomic Polyneuropathy**
- Sweating
- Diarrhea
- Postural hypotension
- Impotence.
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Another Name of **Diabetic Proximal Polyneuropathy**
Diabetic Amyotrophy
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**Diabetic Proximal Polyneuropathy** is common in ......
Type II DM
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CP of **Diabetic Proximal Polyneuropathy**
40
CP of **Diabetic Mononeuropathy**
41
CP of **Diabetic Truncal Neuropathy**
- Recurrent attacks of truncal pain with sensory deficit in the distribution of a single thoracic root.
- Spontaneous recovery occurs in few months..
42
TTT of **Diabetic Neuropathy**
43
Another Name of **Peroneal Muscle Atrophy (BMSN)**
Charcot-Marie-Tooth Disease
44
Compare between Type I,II,III **Peroneal Muscle Atrophy (BMSN)**
- Incidence
- Inheritance
- Age
- CP
45
Compare between Type I,II,III **Peroneal Muscle Atrophy (BMSN)**
- **Incidence**
- Inheritance
- Age
- CP
46
Compare between Type I,II,III **Peroneal Muscle Atrophy (BMSN)**
- Incidence
- **Inheritance**
- Age
- CP
47
Compare between Type I,II,III **Peroneal Muscle Atrophy (BMSN)**
- Incidence
- Inheritance
- **Age**
- CP
48
Compare between Type I,II,III **Peroneal Muscle Atrophy (BMSN)**
- Incidence
- Inheritance
- Age
- **CP**
49
TTT of **Peroneal Muscle Atrophy (BMSN)**
1. Physiotherapy.
2. Ankle splints for foot drop.
50
CP of **Diphtheritic Neuropathy**
1. Starts by true bulbar palsy (within few days).
2. Paralysis of eye accommodation (ciliary muscle paralysis ) > blurred near vision.
3. Generalized sensorimotor polyneuropathy.
4. Diaphragmatic paralysis.
51
Prognosis of **Diphtheritic Neuropathy**
- Good if the child survives.
- Bulbar & accommodation weakness improve within 6 weeks.
- Polyneuropathy recovery takes months.
52
TTT of **Diphtheritic Neuropathy**
- Penicillin G: 600,000 u/12 hours for 14 days.
- Diphtheritic antitoxin: should be given early as 100,000 u IM.
- Assisted ventilation if need.
53
Organism Causing **Leprotic Neuropathy**
Mycobacterium leprae
54
IP in **Leprotic Neuropathy**
Long Incubation period (about 3.5 years) with Insidious onset.
55
Types of **Leprotic Neuropathy**
56
CP of **Leprotic Neuropathy**
57
TTT of **Leprotic Neuropathy**
1. Dapsone 100mg/day + Rifampicin 600 mg/ day (for 1 -2 years).
2. Nerve grafting for severe mononeuropathy with trophic ulcers.
57
Another Name of **Guillian-Barre Syndrome**
Acute Post Infective Polyradiculoneuropathy
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Etiology of **Guillian-Barre Syndrome**
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CP of **Guillian-Barre Syndrome**
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CP of **Guillian-Barre Syndrome**
- Motor
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CP of **Guillian-Barre Syndrome**
- Sensory
Glove and stocking hypoesthesia
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Prognosis of **Guillian-Barre Syndrome**
- Recovery in 3-6 months.
- May be with mild residue in 40% of cases.
- Survival for 8 weeks carries a good prognosis.
63
Investigations for **GBS**
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TTT of **GBS**
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TTT of **GBS**
- NGT
feeding for bulbar palsy.
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TTT of **GBS**
- Assissted Ventilation
...
66
TTT of **GBS**
- SC Heparin
to guard against deep venous thrombosis (DVT).
67
TTT of **GBS**
- Plasmapheresis
must be done in the first 2 weeks
68
TTT of **GBS**
- IVIG
0.4 g/Kg / day for 5 successive days.
