Neurology - peripheral neuropathy (polyneuropathy) Flashcards
1
Q
typical presentation
A
symmetric distal burning or loss of sensation
2
Q
most common causes
A
diabetes mellitus alcohol vitamin B12 deficiency guillain barre vasculitis
3
Q
what pattern is typical?
A
symmetric distal glove and stocking
4
Q
burning foot syndrome
A
burning pain, pins and needles
hyperhidrosis
5
Q
what does an accompanying feature of sensory ataxia suggest?
A
vitamin B12 deficiency
6
Q
diabetes - when are symptoms worst?
A
at night
7
Q
what causes alcoholic polyneuropathy?
A
peripheral nerve injury due to thiamine deficiency
8
Q
investigations
A
nerve conduction studies on sural nerve EMG serum glucose, TFT vitamin B12 and folic acid borrelia antibodies nerve-muscle biopsies
9
Q
nerve conduction studies - primary demyelination
A
reduced impulse conduction velocity
normal amplitude
10
Q
nerve conduction studies - axonal degeneration
A
reduced amplitude
11
Q
symptomatic therapy
A
amitriptyline, pregabalin
opioids
lidocaine/capsaicin patches
physio and foot care
12
Q
myotomes - C5 –> T1
A
C5 --> elbow flexors C6 --> wrist extensors C7 --> elbow extensors C8 --> finger extensors T1 --> intrinsic hand muscles
13
Q
myotomes - L2 –> S1
A
L1 --> hip flexors L2 --> knee extensors L3 --> ankle dorsiflexors L5 --> long toe extensors S1 --> ankle plantar flexors
