Peripheral neuropathy

Question 1

What is Charcot-Marie Tooth disease

Answer 1

A herditary sensorimotor disorder HSMD
chronic demyelinating disorder of the PNS
Presents in 20s

Question 2

Features of Charcot Marie Tooth

Answer 2

Distal muscle wasting and weakness
Champagne bottle appearance 
pes cavus 
absent reflexes 
loss of sensation
calf muscle atrophy

Question 3

What is Guillain Barre syndrome (GBS)

Answer 3

an acute demyelinating disorder of the PNS

Question 4

Features of GBS

Answer 4

pain very common
acute <4 weeks
symmetrical progressive sensorimotor paralysis
areflexia - lose reflexes
associated with post infectious state eg campylobacter
off legs

Question 5

What is chronic inflammatory demyelinating polyradiculoneuropathy

Answer 5

acquired demyelinating condition of the PNS

Question 6

what 5 questions should be asked when it comes to identifying peripheral neuropathy disease

Answer 6

1. which nerves are damaged
2. where are they damaged
3. how are they damaged
4. why are they damaged
5. how to manage this

Question 7

PNS includes ANS, true or false

Answer 7

true

Question 8

modality and function of motor nerves

Answer 8

Aa

muscle control

Question 9

symptoms of damage to motor nerves

Answer 9

muscle weakness and wasting
unsteadiness
reduced power

Question 10

are reflexes absent or present with motor neuron damage

Answer 10

absent

Question 11

is sensation preserved or diminished in motor neuron damage

Answer 11

preserved

Question 12

modality and function of sensory nerves

Answer 12

Aa / AB

fine touch and proprioception

Question 13

symptoms of damage to sensory nerves

Answer 13

reduced vibration and proprioception

Question 14

is power preserved or diminished in sensory neuron damage

Answer 14

preserved

Question 15

are reflexes absent or present with sensory neuron damage

Answer 15

absent

Question 16

modality and function of small fibres

Answer 16

A delta / C

pain and temperature sensation

Question 17

symptoms of small fibre damage

Answer 17

reduced pain and temperature sensation

Question 18

is power preserved or diminished in small fibre damage

Answer 18

preserved

Question 19

are reflexes present or absent in small fibre damage

Answer 19

present

Question 20

modality and function of autonomic nerves

Answer 20

A delta / C

HR, BP, sweating, gut

Question 21

is power preserved in autonomic nerve damage

Answer 21

yes

Question 22

is sensation preserved in autonomic nerve damage

Answer 22

yes

Question 23

are reflexes present in autonomic nerve damage

Answer 23

yes

Question 24

what is pseudoathetosis

Answer 24

large fibre sensory neuropathy with damaged joint position sense

Question 25

what is radiculopathy

Answer 25

damage to the nerve roots

Question 26

what is plexopathy

Answer 26

damage to the plexus

Question 27

what is peripheral neuropathy

Answer 27

damage to the nerves distal to plexus

Question 28

what are the types of peripheral neuropathy

Answer 28

mononeuropathy mononeuritis multiplex length dependent peripheral neuropathy

Question 29

give examples of mononeuropathy

Answer 29

carpal tunnel syndrome cubital tunnel syndrome common fibular nerve palsy

Question 30

what is mononeuritis multiplex

Answer 30

painful, patchy distribution | affects more than 2 isolated nerve areas

Question 31

is mononeuritis multiplex symmetrical

Answer 31

NO | does not have rules of symmetry

Question 32

in which conditions in mononeuritis multiplex seen

Answer 32

DM vasculitis SLE amyloidosis

Question 33

describe distribution of length dependent peripheral neuropathy

Answer 33

glove and stocking distribution symmetrical weakness +/or sensory loss

Question 34

how can nerves be damaged

Answer 34

axonal loss | peripheral nerve demyelination

Question 35

how can peripheral demyelination be classified

Answer 35

acute | chronic

Question 36

examples of acute peripheral demyelinating disease and what is the timescale

Answer 36

Guillain Barré syndrome Acute Inflammatory Demyelinating Polyradiculoneuropathy AIDP days - weeks

Question 37

examples of chronic peripheral demyelinating disease and what is the timescale

Answer 37

Hereditary Sensory Motor neuropathy HSMN aka Charcot Marie Tooth disease Chronic Inflammatory Demyelinating Polyradiculoneuropathy CIDP months - years

Question 38

management of GBS

Answer 38

IVIG +/or plasma exchange

Question 39

causes of axonal neuropathies

Answer 39

``` idiopathic vasculitic paraneoplastic infections drugs/toxins metabolic ```

Question 40

causes of autonomic neuropathies

Answer 40

``` DM amyloidosis hereditary Guillain Barré porphyrias ```

Question 41

what is the ABCDEE of peripheral neuropathies

Answer 41

``` Alcohol B12 / folate deficiency Cancer / CKD Diabetes Every vasculitis Especially ANCA and RA ```

Question 42

which drugs can cause peripheral neuropathy

Answer 42

phenytoin chemotherapy - cisplatin/vincristine alcohol amiodarone