neurology

Question 1

What are the causes of peripheral neuropathy?

Answer 1

DAM IT BITCH

Drugs
Alcohol , Amlyloidosis
Metabolic: DM (30%), acromegaly, hypothyroidism,uraemia, porphyria
Inefection: GBS, HIV, SLE
Tumour: Lung CA
B12, B1 deficiency, B6 excess
Idiopathic (30%)
CTD/ vasculitis: SLE/ PAN
Hereditary (30%)

Question 2

Drugs that can cause peripheral neuropathy

Answer 2

isoniazid
phenytoin
nitrofuratoin
amiodarone
vincristine
cisplatin
heavy metals

Question 3

What are the causes of Sensory Neuropathy?

- cause sensory ataxia

Answer 3

CA - lung, ovary, breats
Paraproteinaemia
Vit B6 intoxication
Sjogren
DM
SYphillis
Vit B12 deficiency
Idiopathic

Question 4

What are the causes of painful peripheral neuropathy?

Answer 4

BAD CAP

Vit B1 / B12 deficiency
Alcohol
Diabetes
CA
Arsenic or thalium poisoning
Porphyria

Question 5

What are the acute causes of mononeuritis multiplex?

Answer 5

Acute (vascular)

• Diabetes
• Polyarteritis nodusa
• SLE, RA

Chronic

• Multiple compressive neuropathy (joint deforming arthritis)
• Sardoidosis
• Acromegaly
• Leprosy
• Lyme disease
• CA
• Idiopathic

Question 6

Causes of motor peripheral neuropathy?

Answer 6

GBS
CIDP
Hereditary motor and sensory neuropathy
DM
Lead poisoning
Acute intermittent porphyria
Multifocal conduction block neuropathy

Question 7

Causes of polyneuropathy with autonomic dysfunction?

Answer 7

Diabetes mellitus
GBS
Amyloidosis
Paraneoplastic (Lung CA)
Sjogren

Question 8

Causes of thickened nerve?

Answer 8

Hereditary motor and sensory neuropathy
Acromegaly
CIDP
Amyloidosis
Leprosy
Sarcoidosis
Neurofibromatosis

Question 9

Causes of fasciculation?

Answer 9

Benign idiopathic fasciculation (most common)
MND
Motor root compression
Maglinant neuropathy

Question 10

What does the nerve conduction study show in

1) Demyelination
2) Axonal lesion

Answer 10

1) Demyelination
- slow conduction velocity
- conduction block
- temporal dispersion
- delayed F waves

2) Axonal
- low amplitude

Question 11

What does electromyography show in

1) acute denervation
2) chronic denervation
3) myopathy

Answer 11

1) Acute demyelination
- fibrillation
- decreased recruitment

2) Chronic denervation
- > 6/52
- increase amplitude
- polyphasic
- decrease recruitment

3) Myopathy
- decrease duration/ amplitude
- fibrillation
- polyphasic

Question 12

MND - signs

Answer 12

• progressive muscle weakness, atrophy, fasciculation, spasticity
• can involve cranial/ bulbar, cervival, thoracic or lumbrosacral
• bladder/ bowel
• tougue fasciculation
• split hand - thenar + 1st dorsal interosseous wasting

sensory and autonomic systems are spared

Question 13

MND - EMG

Answer 13

• chronic denervation –> fasciculation

- active denervation –> fibrillation

Question 14

MND - discussion/ treatment

Answer 14

poor prognosis, 80% die within 5 years, depend on bulbar involement
- always consider ACD

Tx

• Riluzole, slow disease progression
  
  • -> indications:
    
    • duration< 5 years, > 60% FVC, no tracheostomy/ resp failure, ambulatory, able to use ULs, able to swallow

nutrition - PEG
respiratory failure - NIV