PNS-GBS-Cranial Nerves

Question 1

Peripheral Neuropathy

Answer 1

general term for functional degeneration or pathological changes of the peripheral nervous system
(ie damage or impairment to peripheral nerves)

Question 2

PN: symptoms

Answer 2

Start in fingers and toes and move up

Can move slowly or quickly

Question 3

Paraesthesia

Answer 3

Spontaneous sensations of burning, cold, pins and needles or tingling

Question 4

Dysaesthesia

Answer 4

Experiencing unusual sensations by touching or other stimulation

Question 5

Anaesthesia

Answer 5

Lack of or diminished sensation

Question 6

Hypoaesthesia

Answer 6

Diminished sensation

Question 7

Types of sensory loss

Answer 7

Stocking and glove (sensations feel like a stocking or glove)
Loss of Position (don’t know where hands or feet are)

Question 8

Motor Symptoms of PN

Answer 8

Weakness
Muscle cramps
Fasciculation (small muscle bundles contracting quickly)

Question 9

Most common etiology

Answer 9

Diabetes and alcoholism

Most often cause is unknown

Question 10

Diabetes PN

Answer 10

Can be slowed but not cured
Happens in all types
Starts in feet
Can cause non healing lesions

Question 11

Alcohol PN

Answer 11

Can be reversed

From toxins in blood

Question 12

Tricyclic Antidepressants (TCAs)

Answer 12

Chronic forms of pain

Used for PN of deep, burning feeling

Question 13

Neurotonin

Answer 13

• Anti Siezure
• relieve PN pain
• Strong side effects

Question 14

Pyridoxine (B6)

Answer 14

• nutritional support following PN

- up to 250 mg a day

Question 15

Anti-oxidants

Answer 15

• Eliminate toxins which may cause PN

- Improve sx by uptaking glucose

Question 16

Guillian Barre Syndrome

Answer 16

• acute, ascending and progressive PN characterized by poor reflexes and paraesthesia
• less severe than MS
• most common cause of acute/ sub acute paralysis
• happens over several days

Question 17

GBS- etyology

Answer 17

Unknown
Believed to be immune related
-2/3 patients have GI issues weeks before

Question 18

GBS- pathopysiology

Answer 18

Mylens rather than axons

Recovery depends on how fast mylens can be reconstructed

Question 19

GBS- presentation

Answer 19

Ascending pattern of progressive, symmetrical weakness staring in lower extremities
- deep tendon reflexes are diminished

Question 20

GBS- diagnosis

Answer 20

Nerve conductive studies (slower)
Spinal Tap (High CFS protiens

Question 21

GBS- treatment

Answer 21

Hospitalization a must!
Need to be on breathing and feeding tubs
Intraveneous Immunoglobin
Plasmapherisis

Question 22

GBS- prognosis

Answer 22

Usually at weakest by 2 weaks (90% by three)
Recovery anywhere from a few weeks to a few years
Most recover with a few retaining weakness

Question 23

Trigeminal Neuralgia

Answer 23

Characterized by shooting pain across face accompanied by a tic
Diagnosed by symptoms (no definitive test)
Not long lasting, a few times a day

Question 24

Carbamazepine

Answer 24

anti- convulsant

- treats grand mal seizures, bi polar disorder, and TN

Question 25

Bells Palsy- definition

Answer 25

- common neurological disorder affect cranial nerves | - abrupt, unilateral, peripheral facial paresis or paralysis without a detectable cause.

Question 26

Bells Palsy- Presentation

Answer 26

- Rapid onset - mild to severe weakness of side of face - Difficult to smile or close eye of affected side

Question 27

Bells Palsy- Etiology

Answer 27

Herpes Simplex nerve | Compression, cold, injury to nerve

Question 28

Bells Palsy- TX

Answer 28

Corticosteroids- stop inflammation of nerve Anti-virals- if viral is known cause Eye care- protect exposed eye from disease

Question 29

Bells Palsy- Prognosis

Answer 29

85% of patient make full recovery 10% some asymmetry of facial muscles 5% severe sequelae of muscles

Question 30

Acoustic Neuroma- definition

Answer 30

Commonly applied name to small tumor on 8th cranial nerve sheath cells Slow growing and benign

Question 31

Acoustic Neuroma- SX

Answer 31

Unilateral tinneaus or hearing loss dt compression of 8th cranial nerve

Question 32

Acoustic Neuroma- diagnosis

Answer 32

MRI (after unilateral hearing loss) | Audiogram and recorded brain stem audio evoked responses (show if hearing can be saved)

Question 33

Acoustic Neuroma- TX

Answer 33

Microsurgical removal | Stereotactic radiation

Question 34

Spasmatic Tortcollis- definition

Answer 34

characterized by involuntary movements of the head as a result of muscle spasms in the neck and shoulders. No known etiology Progress over time

Question 35

Spasmatic Tortcollis- diagnosis

Answer 35

Symptoms | No known tests

Question 36

Spasmatic tortcollis- treatment

Answer 36

- massage, acupuncture, etc - botox reduces pain - muscle relaxants Benzodiaphines