neuropathy

Question 1

what is radiculopathy

Answer 1

compression of spinal nerve roots –> LM signs

Question 2

what is plexopathy

Answer 2

dysfunction at level of plexus

Question 3

what is brachial neruitis

Answer 3

post infection or trauma –> sudden onset shouler pain, numbness + weakness

Question 4

what is peripheral neruopathy

Answer 4

dysfunction of peripheral nerves due to local damage

Question 5

median nerve roots

Answer 5

C5-T1

Question 6

median nerve motor

Answer 6

LOAF muscles: intrinsic hand + thumb

Question 7

sensory median nerve

Answer 7

thumb + 2.5 digits

Question 8

causes carpal tunnel

Answer 8

RA, pregnancy, diabetes

Question 9

symptoms carpal tunnel

Answer 9

sensory less lateral 3.5 digits, thenar wasting (ape hand) + tinels + phalens +ive (flexion of wrist painful)

Question 10

invx + mx carpal tunnel

Answer 10

nerve studies = prolonged AP // 6 week conservative -of steroid injection + splint –> surgery

Question 11

ulnar nerve roots

Answer 11

C8-T1

Question 12

motor ulnar nerve

Answer 12

adductur pollis, interossu, hypothenar muscles, medial lumbricals

Question 13

sensory ulnar

Answer 13

medial 1.5 fingers

Question 14

symptoms ulnar nerve (cubital tunnel)

Answer 14

sensory loss pinky + ring // ulnar claw// wasting of intrinsic hand and hypothenar

Question 15

radial nerve roots

Answer 15

C5-T1

Question 16

motor radial nerve

Answer 16

triceps, brachioradialus, wrist muscles

Question 17

damage to radial nerve symptoms

Answer 17

wrist drop, sensory web loss between thumb and pointer, paralysis of triceps

Question 18

meralgia paraesthica root damage + nerve

Answer 18

L2/3 - lateral cutaneous nerve of the thigh

Question 19

rf meralgia paraesthica

Answer 19

obese, pregnant, asietces, trauma, iatrogenic surgery

Question 20

meralgia paraesthica symptoms

Answer 20

SENSORY ONLY - neuropathic pain, numb, muscle ache, worse standing

Question 21

invx meralgia paraesthica

Answer 21

pelic compression (below ASIS) –> pain // USS + anaesthetic injection // nerve conduction studies

Question 22

causes foot drop

Answer 22

peroneal nerve legion!!! (L5 radiculopathy, sciatica) // fibular fractures // crossed leg

Question 23

nerve foot drop

Answer 23

common peroneal

Question 24

symptoms common peroneal lesion

Answer 24

foot drop // weak dorsiflexion // weak eversion

Question 25

common drugs that cause peripheral neuropathy (5)

Answer 25

amiodarone // isoniazid // vincristine // nitro // metro

Question 26

what is thoracic outflow syndrome (TOS)

Answer 26

compression of brachial plexus, subclavian artery or vein at site of thoracic outlet

Question 27

who gets TOS

Answer 27

40 // thin people // anatomical anomalies // cervical rib

Question 28

symptoms neurogenic TOS

Answer 28

painless hand weakness + wasting // sensory symtpoms // cold hands

Question 29

symptoms vascular TOS

Answer 29

vein = painful swelling + veins // artery = painful claudication +/- gangrene or ulcer

Question 30

most common cause TOS

Answer 30

vascular

Question 31

invx TOS

Answer 31

xray // CT or MRI // angio

Question 32

mx TOS

Answer 32

conservative + taping // decompression surgery // botox

Question 33

what can cause bell's palsy + who hets it

Answer 33

idiopathic (maybe HSV) // 20-40 // pregnant women

Question 34

symptoms bells palsy

Answer 34

UNILATERAL: LMN --> forehead affected // post-auricular pain // altered taste // dry eyes

Question 35

mx bells

Answer 35

oral pred within 72 hours symptoms // eye lubricant

Question 36

when to refer bells palsy + recovery

Answer 36

3 weeks no improvement --> ENT // 3-4 month recovery

Question 37

facial nerve function

Answer 37

facieal expression, stapedius, ant 2/3 tongue, parasymp to tears + saliva

Question 38

causes bilateral CNVII palsy

Answer 38

sarcoid, GBS, lymes, NFT2

Question 39

causes unilateral facial palsy

Answer 39

bells, ramsay hunt, acoustic neuroma, parotid tumour, MS, stroke (UMN)

Question 40

UMN vs LMN facial palsy

Answer 40

UMN spares forehead // LMN = all facial muscles

Question 41

what is charcot-marie-tooth disease

Answer 41

most common hereditary peripheral neuropathy

Question 42

symptoms charcot marie tooth disease

Answer 42

LMN signs motor loss, sprained ankles, foot drop, high arch, hammer toes, muscle weakness and atophy, hyporeflexia

Question 43

what is HSMN type 1 and inheritance

Answer 43

new term for charcot-marie-tooth // dominant

Question 44

what usually triggers GBS

Answer 44

following food poisoning eg campylobacter jejuni

Question 45

which antibodies may be present in GBS patients

Answer 45

anti-GM1

Question 46

symptoms GBS

Answer 46

early back/leg pain --> ascending weakness of the limbs, reduced reflex --> resp weakness, CN palsy, autonomic dysfunction

Question 47

invx GBS

Answer 47

LP: raised proteins + normal WCC // nerve conduction: decreased motor nerve velocity

Question 48

mx GBS

Answer 48

IV Ig, plasmpopheresis

Question 49

what is miller fisher syndrome

Answer 49

varient of GBS // descending, eyes affected first

Question 50

antibodies miller fisher

Answer 50

anti-GQ1b

Question 51

what is Chronic inflammatory demyelinating polyneuropathy

Answer 51

variant of GBS with onset years

Question 52

what is neuropathic pain

Answer 52

inappropriate response from nervous system dysfunction

Question 53

symptoms neuropathic pain

Answer 53

shooting or burning // tingling // allodynia - pain in response to innocuous things eg light touch // hyperalgesia

Question 54

1st line mx neuropathic pain

Answer 54

amitryp (TCA) // duloxeteine (SNRI) // gabapentin or pregabalin (GABA analogue)

Question 55

2nd line chronic pain mx

Answer 55

opioids, lignocaune, capsaicin, NMDA eg memantine

Question 56

what is complex regional pain

Answer 56

chronic condition that causes pain, usually after surgery or minor injury

Question 57

what is central post-stroke pain

Answer 57

mild hemiplegia + paraesthesia --> allodynia // chorea movements in affected side