Neuropathy

Question 1

Refers to lesions affecting the peripheral nervous system

Answer 1

Peripheral neuropathy

Question 2

Depends on whether myelin or axons are affected, which axons, and where they are affected

Answer 2

Symptoms of Neuropathy

Question 3

Symptoms may include weakness and muscle atrophy, loss of reflexes, and loss of sensation

Answer 3

Neuropathy

Question 4

Peripheral nerve neuropathy affecting all fibers would cause

Answer 4

Sensory, motor, and autonomic symptoms

Question 5

Peripheral nerve neuropathy affecting only small fibers would cause

Answer 5

Pain, temperature, and autonomic loss

Question 6

Peripheral nerve neuropathy affecting myelin (large fibers) would cause

Answer 6

Vibration and position sense loss, with motor loss

Question 7

Peripheral nerve neuropathy affecting only sensory ganglia would cause only

Answer 7

Sensory symptoms

Question 8

Tissue may be damaged, but nerves and nervous system are intact with

Answer 8

Nociceptive pain

Question 9

Arises from lesions in the peripheral and central nervous system

Answer 9

Neuropathic pain

Question 10

May include burning, shooting, stinging pain mixed with areas of numbness

Answer 10

Neuropathic pain

Question 11

A common feature of chronic pain is

Answer 11

Depression

Question 12

What are the primary drugs used to treat neuropathic pain?

Answer 12

Antidepressants and anti-epileptic drugs

Question 13

When symptoms follow a nerve root pattern, it is referred to as

Answer 13

Radiculopathy

Question 14

Often caused by compression of nerve roots from protruding discs

Answer 14

Radiculopathy

Question 15

When symptoms follow a peripheral nerve, it is referred to as

-Often caused by injuries

Answer 15

Mononeuropathy

Question 16

Involves nerve roots and the pattern of loss is along a dermatome or myotome

Answer 16

Radiculopathies

Question 17

In contrast to radiculopathies, are lesions or specific nerves or plexuses

Answer 17

Mononeuropathies and plexopathies

Question 18

A herpes zoster infection arising in the sensory neurons of the dorsal root ganglion of T1 spinal nerves

-May produce just sensory symptoms at the T1 dermatome (usually unilateral)

Answer 18

Radiculopathy

Question 19

A carpal tunnel syndrome may affect all sensory, motor, and autonomic components of the median nerve, distal to the wrist. This is an example of a

Answer 19

Mononeuropathy

Question 20

Caused by a generalized process affecting peripheral nerves

Answer 20

Polyneuropathy

Question 21

May show a distal and symetrical sensorimotor (and possibly autonomic) distribution

Answer 21

Polyneuropathy

Question 22

Polyneuropathy is sometimes called a

Answer 22

Glove and sock pattern

Question 23

The most common causes of polyneuropathy are

Answer 23

Diabetes, alcohol, hypothyroidism, and Vitamin B12 deficiency

Question 24

May result from damage or injury to cell bodies, axons, or myelin sheaths

Answer 24

Peripheral neuropathy

Question 25

Axonal damage produces

Answer 25

Wallerian Degeneration (Or dying forward)

Question 26

Distal axonal degeneration, chromatolysius, and recruitment of macrophages

Answer 26

Wallerian degeneration

Question 27

The proximal stump after a neuron lesion can recover at a rate of

Answer 27

1-2 mm/day

Question 28

Conditions that affect the health of the neuron such as metabolic diseases causes the

Answer 28

Dying of back axons

Question 29

Longer axons are affected first, resulting in the

Answer 29

Distal extremities being affected first

Question 30

Occurs when myelin sheaths are damaged by trauma or disease

Answer 30

Segmental demyelination

Question 31

May be affected secondarily to axonal death

Answer 31

Myelin

Question 32

Symptoms of demyelination are detected by nerve conduction tests which detect

Answer 32

Conduction block and slowed CV

Question 33

Myelin and conduction can return in

Answer 33

Days to weeks

Question 34

Trauma affecting myelin can be thought of as a

Answer 34

Nerve "concussion"

Question 35

Note that it is only when the axon is interrupted that you will see

Answer 35

Muscle atrophy

Question 36

What are two causative disorders/agents that result in nutritional/metabolic causes of peripheral neuropathy

Answer 36

Diabetes Mellitus and Vitamin B12 deficiency

Question 37

An autoimmune disease that can result in non-traumatic peripheral neuropathy

Answer 37

Guillain-Barre Syndrome

Question 38

What is an inherited disorder that causes non-traumatic peripheral neuropathy?

Answer 38

Charcot-Marie-Tooth Neuropathy

Question 39

Affects 1.9% of the population -most common complication in this population

Answer 39

Diabetic Neuropathy

Question 40

The greatest source of morbidity and mortality in diabetes patients

Answer 40

Diabetic neuropathy

Question 41

Accounts for greater than 80% of patients with diabetic neuropathy

Answer 41

Length-dependent diabetic neuropathy

Question 42

Length dependent polyneuropathy gives a -Produced by most nutritional, metabolic, and toxic diseases

Answer 42

Glove and stocking pattern of sensory loss

Question 43

Symptoms include parethesias, dyesthesias, numbness, tingling, and burning -Motor weakness of the distal limbs is also present

Answer 43

Length dependent polyneuropathy

Question 44

Length dependent polyneuropathy can lead to trophic changes like

Answer 44

Calluses and plantar ulcers

Question 45

More affects in ALL distal neuropathies

Answer 45

Sensory neurons

Question 46

The most common metabolic neuropathy -May affect peripheral nerves, optic nerves, spinal cord, and brain

Answer 46

B12 deficiency

Question 47

Symptoms of neuropathy from B12 deficiency include the distal limbs, beginning more commonly in the

Answer 47

Upper Limb

Question 48

The most common feature of peripheral neuropathy from B12 deficiency is

Answer 48

Loss of vibration sense

Question 49

Vitamin B12 neuropathy may primarily or secondarily affect lateral and dorsal columns of the spinal cord. This is called

Answer 49

Subacute combined degeneration

Question 50

Therefore, ataxia and spasticity can occur together with the symptoms of

Answer 50

Peripheral neuropathy

Question 51

Can see in vegetarians or people with gluten sensitivity or malabsorption syndromes

Answer 51

B12 deficiency

Question 52

Without B12, is abnormal -NCV will decrease

Answer 52

Myelin production

Question 53

Needs to be differentiated from MS

Answer 53

B12 deficiency

Question 54

The most common cause of acute paralysis seen in clinical practice -Also called Acute Inflammatory Demyelinating polyneuropathy (AIDP)

Answer 54

Guillain Barre

Question 55

The most rapidly progressing and potentially fatal form of neuropathy

Answer 55

Guillain Barre

Question 56

Primarily motor with ascending symmetric paralysis

Answer 56

Guillain Barre

Question 57

May begin with paresthesias in toes and fingers and aching in the thighs and back

Answer 57

Guillain Barre

Question 58

What are two major features of Guillain Barre?

Answer 58

Nerve conduciton velocity is decreased and there is increased protein in CSF w/ normal cell count

Question 59

60% of the time, Guillain Barre begins how long after an infection or vaccination?

Answer 59

1-3 weeks

Question 60

Widespread inflammatory process that affects myelin sheaths

Answer 60

Guillain Barre

Question 61

The 2 most important diagnostic tests for Guillain Barre are

Answer 61

CSF analysis and Nerve Conduction Tests

Question 62

The results of these tests are

Answer 62

Increased protein in CSF and decreased NCV

Question 63

Classified s hereditary motor and sensory neuropathy

Answer 63

Charcot-Marie-Tooth Disease

Question 64

Which form of Charcot-Marie-Tooth (CMT) disease affects 1. ) Myelin 2. ) Axons

Answer 64

1. ) CMT1 | 2. ) CMT2

Question 65

The most common form of CMT: produces a combined motor sensory neuropathy

Answer 65

CMT1

Question 66

CMT1 primarily affects distal muscle, particularly affecting the

Answer 66

Peroneal nerve

Question 67

Because of the demyelination, are not affected by CMT1

Answer 67

Small fiber types carrying pain and temperature

Question 68

The typical onset of CMT1 is in

Answer 68

Late childhood

Question 69

Identifiable by the slowly progressive nature and by the reduced conduction velocity in all nerves

Answer 69

CMT1,