Peripheral Nerve Disorders Flashcards Preview

Elysse NPTE NM > Peripheral Nerve Disorders > Flashcards

Flashcards in Peripheral Nerve Disorders Deck (17):
1

Wallerian degeneration

Involves axon and sheath distal to site of interruption.
Sheath doesn't regenerate

2

Segmental demyelination

Involves sheath. It remyelination can occur to restore function.

(Guillain barre)

3

Axonal degeneration

Involves sheath and axon. Distal to proximal.
(Peripheral neuropathy)

4

Polyneuropathy

Bilateral symmetrical nerve involvement.
Legs more than arms, distal before proximal.

5

Radiculopathy

Involvement of the nerve root

6

neuropraxia

temporary disruption of nerve function (compression)

7

axonotmesis

axon interruption and loss of function (crush injury)
regen possible

8

neurotmesis

severance of the nerve. regen fails without surgery

9

Trigeminal Neuralgia

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.

10

Bell's Palsy

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.

11

Bulbar Palsy

weakness or paralysis to mm innervated by nerves with nuclei of the lower brainstem: face, tongue, larynx, pharynx.

12

Differentiate bulbar palsy from myasthenia gravis

both involve bulbar system but bulbar palsy doesn't affect the ocular muscles***

13

Guillain-Barre

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

14

ALS

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.

15

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.

16

Role of Riluzole

glutamate antagonist - may help to delay disability and prolong survival with ALS, especially pseudo bulbar type

17

Postpolio Syndrome

New onset of weakness in patient with confirmed hx of polio.
Etiology: unknown - may be due to hyper functioning of nerves leading to denervation
Characteristics: asymmetrical weakness in weak mm groups, abnormal fatigue, myalgia and hypersensitivities, slow progression, cold intolerance, damage to reticular formation - change in concentration, attention. NO sensory involvement.
PT: