peripheral neuropathy;bennett Flashcards

(34 cards)

1
Q

which neuropathy have loss of individual myelin internode. demyelination in axons can regenerate, but does not have same integrity

A

Segmental demyelination

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2
Q

occurs after transection of axon: no regeneration

A

wallerian

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3
Q

what are the Toxic causes to neropathy? which one causes permanent impairement?

A

drug intox.

heavy metals (permanent impairement)

organic compounds

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4
Q

Degenerated but still has some integrity so dysfunction can be halted and nerve able to have full recovery

A

Axonal degeneration

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5
Q

what is the main infection for neuropathy

A

VIRUS!!! Leprosy, HIV, CMV , Dherpes, hepatitis, etc

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6
Q

Classification of neuropathy

A

Diabetic
Alcoholic
Nutritional
Gullain-Barre

Toxic, hereditary, recurrent, anyloidosis, porphyria, infectious, systemic, tumor

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7
Q

Motor paralysis

A

this will be seen in later finding to developt.

muscles of feet and legs affected first and most severely and slowly progress up to leg and thigh

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8
Q

pattern 1 vs pattern 2 sensory loss

A

pattern 1: loss of touch pressure, vibratory, 2 points discrimnation, as disease worsen it progresses proximally and includes loss of pain and temp sensation (larger fibers–>smaller fibers)

pattern 2:primary loss of pain and temp with lesser impariment of pressure and vibratoy and position

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9
Q

where is paresthesia and dysestheisa prominent

A

hands and feet

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10
Q

what are the most two frequent manifestion for PN and where does it usaully occur in?

A

anhyrdosis and orthostatic hypertension which occurs in small fiber poly neuropathy

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11
Q

Acute axonal polyneuropathy Cause? duration? key components?

A

evolves over several day;

cause: porphyric neuropathic massive intoxication

present with renal and liver failure : KEY

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12
Q

what neuropathy can be seen in parkinsons? what is its characteristics? sensory or motor deficit?

A

subacute axonal polyneuropathy

evolves in weeks, tends to be chronic overtime

sensory vs motor deficit dependent of toxic agent

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13
Q

chronic axonal polyneuropathy

A

progress 6 months-60 yrs

NO systemic disorder *******

MOTOR deficit

genetically determined neropathy: autosomal dominant

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14
Q

acute demyelinating polyneuorpathy cause? characteristic? what are the only manifestions?

A

virus precedes to neuropathy

KEY: areflexic motor paralysis, mild sensory disturburance: only manifestion****

acute rise of total protein in CSP in 1st week

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15
Q

which neuropathy tend to be relapsing and remitting neuropathy? cause?

A

subacute demyelinating polyneuropathy

diphtheria toxin

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16
Q

chronic demyelinating polyneuropathy

A

wide variety of disorder
motor and sensory prob: mixed

no specific characteristic

17
Q

Charcot vs Roussy-levy

A

charco:
- storkleg appearance (MAIN difference)
- thenar and hypothenar wasting
- pes cavus(high arch), hammertoes
- motor and sensory loss

Roussy-levy:

  • static tremor
  • sensory loss only
  • pes cavus, claw foot
18
Q

Guillan-Barre syndrome
cause?
characteristics? PE?

Lab studies?

A

virus triggering syndrome

acute ascending motor paraylsis: demyelinating disease
Most common: weakness

initial: leg pain, tingling, numbness

reflexes become absent
***respiratory failure

CSF: protein is increased without PLEOCYTOSIS

19
Q

Neuropathy with inflammation

what test do you use?

A

elevated csf protein, low grade inflammatory,

similar to GBS except chronic

muscle weakness

Sed rate: specific to inflammatory process
-it is senstive but no specific

20
Q

tx for guillian barre syndrome

A

plasmapharesis immunoglobulin

21
Q

which neuropathy is consistent with axonal degeneration

A

neuropathy with disproteinemia

22
Q

usually sensorimotor caused by axonal degneration (pain and paresthesias)

which loss occurs first?

A

alcohol neuropathy

mainly sensory occurs first for a long period of time.

23
Q

drug induced neuropathy cause

A

renal or hepatic dysfunction

24
Q

what causes diabetic neuropathy

A

long standing hyperglycemia

25
what is the most common form of diabetic neuropathy? what loss is presented first?
distal symmetric polyneuropathy; sensory present first, and motor present much later stocking-glove distribution 1st pattern sensory loss
26
Autonomic neuropathy is associated with what neuropathy?
somatic polyneuropathy atrophy of skin, loss of nails: predisposing factor to someone to develop charcot -advanced neuropathy: muscle weakness--> muscle concracure---> crowing of toes, metatarsal heads, etc
27
nerve biopsy: what will it reveal
demyelination or axonal damage may confirm vasculitis (detect if vessels are closed off to cause nerve damage?) fibrosis within a nerve biopsy always done on SENSORY NERVE
28
medication tx of painful diabetic neuroapthy
TCA and gabapentin* TCA: first line of tx use gabapentin before lyrica
29
if there is a vascular component of painful diabetic neuropathy, what drug do you use?
pentoxifyline---alters viscosity and blood flow: changes shape of RBC: so it takes awhile to be effective
30
if pt has superficial pain, what is the good medication to use?
capsaicin
31
Transcutaneous electric stimulation (TENS) usage
neuro-physiological and chemical effect utilized for pain management
32
Accupuncture usage
the points coincide with myoneural junctions. endorphins which promote analgesia enkephalins which block incoming pain signal
33
Amitriptyline combo with what cause systematic relief and will prolong benefit of therapy
electrotherapy
34
Magnetic bio-stimulation in diabetic peripheral neuropathy
pathophysiology: closure produces excess of charged K_ on the inner side on nerve membrane leading to depolarization magnetic selectively induces hyperpolararization or repolarziation, which will allow a retun to baseline axonal potential