Numbness Flashcards
(13 cards)
What does the pattern of numbness tell you about the lesion site?
Glove-and-stocking = peripheral neuropathy; dermatomal = radiculopathy; unilateral body and face = brainstem or cortical lesion.
What are common causes of symmetrical distal numbness?
Diabetic polyneuropathy, alcohol-related neuropathy, B12 deficiency, hypothyroidism, uremia, chemotherapy.
What is a common cause of dermatomal numbness with shooting pain?
Nerve root compression (radiculopathy), often due to disc prolapse or spondylosis.
What are signs of a sensory level on examination?
A horizontal line below which sensation is altered or absent, suggesting spinal cord pathology (e.g., cord compression, myelitis).
What condition presents with patchy, painful numbness and mononeuritis multiplex?
Vasculitis (e.g., polyarteritis nodosa, Churg-Strauss), diabetes, or sarcoidosis.
What are red flags in a patient with new limb numbness?
Rapid progression, sphincter involvement, weakness, ataxia, or signs of spinal cord compression.
What vitamin deficiency can cause combined sensory ataxia and numbness?
Vitamin B12 deficiency (subacute combined degeneration of the cord).
What is the typical presentation of carpal tunnel syndrome?
Numbness/tingling in the median nerve distribution (thumb, index, middle fingers), often worse at night.
What investigations are useful in peripheral numbness?
Bloods (glucose, B12, TSH, renal and liver function), nerve conduction studies, MRI spine/brain if central cause suspected.
What is the role of nerve conduction studies (NCS)?
To confirm and localize peripheral nerve dysfunction, and differentiate between axonal vs demyelinating neuropathies.
How is diabetic neuropathy managed?
Glycemic control, neuropathic pain treatment (e.g., duloxetine, pregabalin), foot care to prevent ulcers.
How is carpal tunnel syndrome treated?
Wrist splinting, steroid injection, surgical decompression if severe or persistent.
What is the management of suspected spinal cord compression causing numbness?
Urgent MRI spine and neurosurgical referral; high-dose steroids may be considered if malignancy suspected.
