neuropathies

Question 1

Demyelination:

• what is the pathophysiology?
• what are 2 causes of this neuropathy?
• what is the treatment?

Answer 1

Demyelination:
Myelin is removed
Affects conduction

Causes:
Gillian Barre-syndrome
Post infective demyelinating polyneuropathy

HMSN
Hereditary motor and sensory neuropathy

treatment:
IVIg –pooled immunoglobulin from donors
Steroids
Azathioprine, mycophenalate, cyclophosphamide

Question 2

Axonal degeneration:

• what is the pathophysiology?
• what are causes of this neuropathy?
• what is the treatment?

Answer 2

Pathophysiology:
-direct damage to axon

Causes - toxic neuropathies:
Toxic neuropathies: 
ETOH 
Drugs 
Industrial toxins (Lead) 

Treatment
Treat cause
Physiotherapy, orthotics, neuropathic pain relief

Question 3

Focal compression

• what is this
• what is the cause?

Answer 3

Myelin is locally disrupted due to something pressing on it

-entrapment neuropathies

Question 4

Infarction:

• what is the pathophysiology
• what are 2 causes
• what is the treatment?

Answer 4

Reduced blood supply due to disruption of the vasa nervorum

Diabetes – microvascular complication
vasculitis

Treatment:
Pulsed IV methylprednisolone and cyclophosphamide

Question 5

Infiltration:

• what is the pathophysiology?
• what are the causes?

Answer 5

whole nerve is infiltrated by inflammatory cells which leads to breakdown of the nerve

Granulomas – sarcoid/TB
malignancy

Question 6

For a length dependant peripheral neuropathy - what distribution is the loss?

Answer 6

glove and stocking