Peripheral Neuropathy Flashcards Preview

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Flashcards in Peripheral Neuropathy Deck (30)
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1
Q

features of large motor fibre damage?

A
weakness
unsteadiness
wasting
reduced power
normal sensation
absent reflexes
2
Q

features of large sensory fibre damage?

A
numbness
paraesthesia
unsteadiness
normal power
vibration and JPS reduced
absent reflexes
3
Q

features of small fibre damage?

A
pain
dyesthesia
normal power
pin prick and temperature sensation reduced
reflexes present
4
Q

features of autonomic nerve damage?

A
dizziness
impotence
nausea and vomiting
normal power
normal sensation
reflexes present
5
Q

types of motor fibre?

A

myelinated A alpha

6
Q

sensory fibres?

A
myelinated A alpha/beta (touch, vibration, proprioception)
thinly myelinated A delta (cold, pain)
unmyelinated C (heat, pain)
7
Q

autonomic fibres?

A

thinly myelinated A delta

unmyelinated C fibres

8
Q

pseudoathetosis?

A

due to loss of proprioception (A alpha/beta fibres)

causes writhing hand motion when eyes are closed

9
Q

radiculopathy?

A

nerve root is damaged

- most common cause = disc prolapse but can be an inflammatory cause

10
Q

plexopathy?

A

damage in plexus

11
Q

peripheral neuropathy?

A

damage to peripheral nerve

12
Q

3 examples of types of peripheral neuropathy?

A
mononeuropathy (e.g wrist drop)
mononeuritis multiplex (lost of nerves picked off)
length dependant peripheral neuropathy
13
Q

length dependant peripheral neuropathy?

A

weakness/sensory loss in length dependant pattern

classic glove and stocking pattern but can be more severe and spread to more central areas

14
Q

symmetrical vs asymmetrical wasting in muscle?

A
symmetrical = more likely to be length dependant peripheral neuropathy
asymmetrical = more likely to be compression on single nerve (carpal tunnel/compression by tumour) or something worse like MND
15
Q

what is mononeuritis multiplex?

A

associated with vasculitis
asymmetrical patchy neuropathy in context of other illness
lots of nerve affected

16
Q

radiculopathy follows what pattern?

A

spinal nerve dermatomes and myotomes

17
Q

most common plexopathy?

A

traction injury in arm (e.g erbs palsy)

18
Q

presentation of plexopathy?

A
often have a lot of pain
widespread symptoms (e.g whole limb)
19
Q

old people vs young people with nerve damage?

A
old = axonal loss
young = demyelination (e.g guillan barre)
20
Q

neurophysiology?

A

testing which can determine whether axonal loss of demyelination

21
Q

features of demyelinating neuropathy?

A

acute (days to weeks)
- e.g Guillaine barre syndrome or AIDP)
chronic (months to years)
- CIDP (chronic inflammatory demyelinating polyradiculopathy)
- hereditary sensory motor neuropathy neuropathy (AKA charcot-Marie-Tooth disease)

22
Q

what is GBS?

A

progressive paraplegia over days up to 4 weeks
associated sensory symptoms precedes weakness
can be fairly normal initially then go “off legs” and loose reflexes
often after illness/infection
pain very common
peak symptoms 10-14 days into illness
can have normal examination initially

23
Q

how is GBS managed?

A

IV immunoglobulin infusion and/or plasma exchange

24
Q

cause of death in GBS?

A

autonomic failure (cardiac arrhythmia)

25
Q

what is hereditary neuropathy?

A

AD, AR, X linked
pure motor, sensory, sensorimotor…..
….
typically have wasted (champagne bottle deformity) of tibial muscles
deforming arthropathy of hands and feet (e.g pes cavus)

26
Q

types of axonal neuropathy?

A

idiopathic
vasculitis (likely to cause disability?)
paraneoplastic
infections (HIV, syphilis, lyme, hepatitis)
drugs/toxins (alcohol, amiodarone, phenytoin, chemo)
metabolic (diabetes, hypothyroid)

27
Q

chronic autonomic neuropathy?

A

diabetes (gastroparesis)
amyloidosis
hereditary

28
Q

acute autonomic neuropathy?

A

GBS

porphyria

29
Q

treatment of axonal peripheral neuropathy?

A
treat cause
symptomatic treatment (physio, orthotics, neuropathic pain relief)
30
Q

how can radiculopathy and peripheral nerve compression be differentiated?

A

radiculopathy = shooting pains