Flashcards in Peripheral Nerve Disorders Deck (17):
Involves axon and sheath distal to site of interruption.
Sheath doesn't regenerate
Involves sheath. It remyelination can occur to restore function.
Involves sheath and axon. Distal to proximal.
Bilateral symmetrical nerve involvement.
Legs more than arms, distal before proximal.
Involvement of the nerve root
temporary disruption of nerve function (compression)
axon interruption and loss of function (crush injury)
severance of the nerve. regen fails without surgery
degeneration or compression (tumor, age) of the trigeminal nerve
Characteristics: UNILATERAL neuropathic pain along mandibular and maxillary branches. Autonomic involvement: worse with stress and cold, better with relaxation.
CN VII lesion by unknown acute inflammatory compression.
Characteristics: UNILATERAL facial muscle weakness or paralysis, loss of salivation control, acute onset with weeks-month recovery. Change in taste of ant 2/3 tongue. No loss of sensation.
weakness or paralysis to mm innervated by nerves with nuclei of the lower brainstem: face, tongue, larynx, pharynx.
Differentiate bulbar palsy from myasthenia gravis
both involve bulbar system but bulbar palsy doesn't affect the ocular muscles***
LMN polyneuritis affecting all peripheral nerves and CN.
Etiology: unknown, usually occurs after illness or infection of GI or resp
Characteristics: bilateral distal to proximal, motor > sensory, quick progression and slow but usually complete recovery
Medical: plasmapheresis, IVG, analgesics
PT: pulmonary PT, energy conservation, avoid overuse
Amyotrophic Lateral Sclerosis: progressive UMN and LMN degeneration (anterior horn cells including CST and CBT)
Etiology: unknown, some viral or autoimmune, 5-10% genetic
Characteristics: death in 2-5 years, variable symptoms, muscular weakness spreads over time, spasticity and hyperreflexia, usually no sensory involvement, pain, respiratory involvement, sparing of bowel and bladder, normal cognition, depression common.
Stages of ALS
I. early, focal weakness, hand cramping and fasciculations
II. moderate weakness in mm groups, some atrophy, MOD I
III. Severe weakness, increased fatigue, moderate functional limitations but ambulatory.
IV. severe weakness and wasting LE, mild UE, MOD A and wheelchair used.
V. deterioration of mobility and endurance, severe weakness of UE and LE. UMN signs, loss of head control, MAX A
VI. bedridden, dependent, progressive respiratory distress.
Role of Riluzole
glutamate antagonist - may help to delay disability and prolong survival with ALS, especially pseudo bulbar type