Flashcards in Peripheral Neuropathies Deck (59):
What is peripheral neuropathy?
outside of the brain and spinal cord
Peripheral neuropathy - cx: US and WW?
What is mononeuropathy?
affecting only one nerve
Mononeuropathy - cx?
Mononeuropathy - ex?
winging of scapula
more than one nerve- NOT symmetrical
Multiple mononeuropathy - ex?
wake up and hand falls asleep: ulnar and median n.
more than one nerve - SYMMETRICAL
Polyneuropathy - classic sx?
Polyneuropathy - cx?
Diabetic peripheral neuropathy- cx?
microvascular prob: not enough blood to the nerves
Diabetic peripheral neuropathy categories?
Diabetic sensorimotor polyneuropathy
Asymmetric diabetic neuropathy
Diabetic sensorimotor polyneuropathy?
mixed neuropathy: sensory, motor, autonomic
Diabetic sensorimotor polyneuropathy - sx?
stocking globe sx
usually starts from the feet then makes its way up to the hands (length dependent neuropathy)
Diabetic sensorimotor polyneuropathy - PE?
Asymmetric diabetic neuropathy - sx?
6th CN - abducens (painless double vision-diplopia)
Asymmetric diabetic neuropathy -hx?
LONG STANDING DIABETES
Diabetic sensorimotor polyneuropathy and asymmetric diabetic neuropathy - tx?
opioids - avoid
Chronic renal failure associated neuropathies - uremic neuropathy-sx?
Uremic neuropathy - tx?
dialysis - stabilize neuropathy
renal transplant - resolves neuropathy
diabetic peripheral neuropathy
Axonal vs demyelination?
axonal-not treatable (permanent damage); length dependent
demyelination - treatable; myelin sheath (axon is spared)
Infection related neuropathies?
Cytomegalic Virus (HIV/AIDs)
paresis of CN VII (facial n)
Bell's palsy -sx?
drooping of one side of face
diff from stroke: able to frow brow
unilateral loss of taste
hyperacusis (hearing sensitivity)
Bell's palsy - cx?
Bell's palsy - PE?
sensory is intact
Bell's palsy- tx?
Ramsay Hunt syndrome?
reactivation of herpes zoster
DO NOT MISS -NERVE IS DYING!!
Ramsay Hunt syndrome - sx?
vesicular outbreak in auditory canal/pharynx
can have sx of Bell's palsy but this is insidious, Bell's palsy is acute
borrelia burgdoferi infxn
Lyme dz - tx?
Lyme dz - sx?
Postherpetic neuralgia -sx?
pain after shingles (NOT only CN VII- throughout body)
Postherpetic neuralgia - tx?
chronic - d/t repeated exposure to toxic (ie. lead poisoning)
can be: motor (lead), sensory (ethambutol), autonomic (vincristine), or all
pts who are going undergoing chemo
Toxic neuropathies - tx?
pyridoxine to prevent and treat isoniazid
lack of thiamine B1, pyridoxine B6, vit B 12
What can B12 deficiency cx?
pernicious anemia --> sensory neuropathy d/t lack of intrinsic factor from the gut
Nutritional neuropathies - cx?
poor nutrition (eating disorders)
malabsoprtion syndrome (celiac dz, no gut - trauma)
Nutritional neuropathies -sx?
Charcot marie tooth?
most common inherited dz
Charcot marie tooth - sx?
SENSORY AND MOTOR neuropathy
no until late years - physical deformities of foot start to show
Charcot marie tooth - PE?
wasting of distal leg muscles - can lead to arm and hands
Guillian - Barree syndrome?
Guillian baree syndrome?
Guillian baree sx - sx?
ascending paralysis over hours to days
may have autonomic instability -> ventilator support
Guillian baree sx- PE?
Guillian baree sx - labs?
-norm cell ct
Guillian baree sx - cx?
1-3wks after infection - Campylobacter jejuni
Guillian baree sx - prognosis?
good; all recover w/in months-yr
Guillian baree sx- tx?
HD IV immune globulin
Trigeminal neurlagia - sx?
shock like lasts 1-2 sec --> wincing
Trigeminal neurlagia - PE?
able to find trigger zone
Trigeminal neurlagia - tx?