PNS clinical correlates Flashcards
(24 cards)
Guillain-Barre Syndrome (GBS) is what?
demyelination of peripheral axons which begins several weeks following a GI or respiratory infection (due to an autoimmune response)
Respiratory support is often needed in GBS until what?
schwann cells can successfully re-myelinate the nerves
can patients recover from peripheral neuropathy in GBS?
YES
what treatment can be used in GBS peripheral neuropathy?
IV immune globulin
what is leprosy (hansen disease) caused by?
mycobacterium leprae
what is the most common treatable neuropathy worldwide?
leprosy (hansen disease )
once the bacteria enters the body through the skin what does the organism preferentially gain assess to?
unmyelinated axons
what are some symptoms associated with leprosy (hansen disease)
skin lesions and profound sensory loss (TP) due to ischemia/compression of the peripheral nerves
what treatments are used for leprosy (hansen disease)
antibiotics
who are most susceptible to lead poisoning?
children because their brain and CNS are not fully developed
Lead traces in the blood can lead to what conditions?
encephalopathy with diminished IQ, attentional problems, and learning disabilities. Higher levels can result in mental retardation, coma or death
what are some symptoms of lead poisoning?
distal muscles more than proximal
(bilateral arm weakness and wasting, motor neuropathy, and focal weakness of extensor muscles of fingers, wrist and arms)
Is sensory affected in lead poisoning?
NO
how can you distinguish a UMN syndrome from lead poisoning?
loss of muscle mass (remember that atrophy is associated with LMN syndrome)
what is alcoholic polyneuropathy caused by?
neurotoxic effects of alcohol associated malnutrition (Vitamin B1 –> thiamin deficiency)
what symptoms are associated with alcoholic polyneuropathy?
sensory loss in lower legs and progresses to motor losses in the legs
is nerve conduction normal in patients with alcoholic polyneuropathy?
yes
Alcoholism of about how many years establishes a high risk for alcoholic neuropathy?
10 + years
Diabetic neuropathy is usually seen in what kind of diabetics?
insulin dependent
what kind of symptoms are seen?
1) Autonomic (dry skin)
2) Motor (usually asymmetric)
3) Sensory ( usually symmetric)
Sensory symptoms for a diabetic usually begin in both legs, this loss reflects what?
losses reflect abnormalities of unmyelinated axons carrying pain and temperature in a stocking distribution
What structures are very vulnerable to hyperglycemia?
DRG and unmyelinated axons
how does this problem of high vulnerability to sugar come about?
this may be due to lack of nutrient and protein supply to distant parts
what does NCV, EMG and CSF show for Guillian-barre syndrome?
NCV–> sensitive to demyelination (conduction of impulses through the nerve slows or is blocked)
EMG–> lack of nervous stimulation
CSF–> sometimes elevated protein
