Neuropathies and encephalopathies

Question 1

Follows herpes zoster. Allodynic, shooting, lancinating (tearing or cutting) pain. Commonly hyperesthesia in involved dermatome. -Gabapentin, lidocaine patches

Answer 1

Post Herpetic Neuralgia

Question 2

-Asterixis, tremor, dysarthria, delirirum, drowsiness, stupor, coma -Increased serum ammonia, LFTs -Lactulose, neomycin sulfate -Hypernatremia 2/2 intense lactulose use

Answer 2

Hepatic encephalopathy

Question 3

-Peripheral nervous system disorder -Foot deformities/gait abnormalities in childhood. Polyneuropathy, distal weakness and wasting. -EMG -Supportive care

Answer 3

Charcot-Marie-Tooth Dz

Question 3

-Chronic, inhereted, sensory neuropathy -Localized itch. Usually affects intrascapular area.

Answer 3

nostalgia paresthetica

Question 5

Encelopathy d/t thiamine (B1) deficiency -Confusion, ataxia, and nystagmus….followed by lateral rectus muscle weakness

Answer 5

Wernicke encephalopathy

Question 6

Mono: sensory/motor/mixed deficits restricted to territory of affected nerve Diffuse Polyneuropathies: symmetric, sensory/motor/mixed deficits often most marked distally -EMG

Answer 6

Peripheral neuropathy

Question 7

-Symmetric sensory/motor/both deficits, often starting distally. Areflexia (hypo/absent DTRs). Can be tachycardia/arrhythmic -May be seen s/p infix -CSF with increased protein but normal cell count (albuminocytology) -Supportive care, PLEX, IVIG

Answer 7

Acute Idiopathic Polyneuropathy (Guillain-Barré)

Question 8

Numbness, tingling, burning of outer thight

Nerve compression

Answer 8

Meralgia paresthetic