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Neurology > 3(E): Peripheral Polyneuropathies > Flashcards

3(E): Peripheral Polyneuropathies Flashcards

1
Q

What is a peripheral neuropathy

A

Damage to multiple peripheral nerves

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2
Q

Give 3 features of neuropathies (compared to myopathies)

A
  • Distal muscles affected first
  • Early muscle waisting
  • Diminished or absent reflexes
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3
Q

What genetic condition can cause poly neuropathies

A

Charcot marie tooth

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4
Q

What are acquired causes of polyneuropathy

A

Inflammatory: Gullian Barre, Chronic Demyelinating Polyneuropathy
Toxin: Alcohol, Lead

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5
Q

What toxins can cause polyneuropathy

A

Alcohol, Lead

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6
Q

What causes alcoholic neuropathy

A

Direct toxin effect of alcohol

Vitamin B12 deficiency

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7
Q

How does alcoholic neuropathy present

A

Loss sensation prior to motor symptoms

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8
Q

What does vitamin B12 deficiency cause

A

Subacute combined degeneration spinal cord

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9
Q

What tract is impacted first in subacute combined degeneration spinal cord

A

DCP

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10
Q

How does diabetic neuropathy present

A

Loss of sensation in glove and stocking distribution. Burning in the feet worse at night

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11
Q

What is the inheritance pattern of Charcot Marie Tooth

A

Autosomal dominant

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12
Q

What is predominantly lost in Charcot Marie Tooth

A

Motor symptoms

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13
Q

What are 3 distinct features of CMT

A

Pes cavus = high arch foot
Hammer toes
Stork legs = atrophy calf muscles

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14
Q

What is a common presenting story for CMT

A

Recurrent sprained ankles

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15
Q

What is ordered for CMT

A

NCS

Nerve Biopsy

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16
Q

What is seen on NCS in CMT

A

reduced conduction velocity

17
Q

What is seen on nerve biopsy in CMT

A

myelination and then demyelination = onion peel appearance

18
Q

What is Gullian Barre Syndrome

A

Immune-mediated demyelinating peripheral polyneuropathy

19
Q

What do patients experience before neuronal symptoms in GBS

A

URTI or GI Infection 1-4W prior

20
Q

What pathogens cause GBS

A
  • Campylobacter Jejuni
  • CMV
  • EBV
21
Q

Explain symptoms of Gillian barre

A

Progressive weakness in all four limbs to cause paralysis. It is an ascending paralysis - meaning it starts in the legs and progresses to the arms. Proximal muscles are affected first.

Areflexia
Autonomic Dysfunction - arrhythmia, gastroparesis and voting dysfunction

22
Q

Describe reflexes in Gullian Barre

A

Areflexia

23
Q

What autonomic dysfunction may occur in gullian barre

A
  • Arrhythmia
  • Gastroparesis
  • Voiding dysfunction
24
Q

What is a late sign of Guillian barre

A

Sensory Loss

Landry Paralysis

25
Q

What is Landry paralysis

A

Involvement of respiratory muscles - medical emergency

26
Q

What is a variant of GBS

A

Miller-Fisher

27
Q

What is Miller-Fisher Syndrome

A

Ophthalmoplegia and ataxia

28
Q

What muscles are affected first in Miller-Fisher

A

Extra-occular muscles

29
Q

Describe muscle involvement in Miller-Fisher

A

In contrast to GBS, it is a descending paralysis. Affects arms before legs. Usually starts with eye muscles

30
Q

What antibodies are present in Miller-Fisher

A

anti-GQ1b antibodies

31
Q

What investigations are ordered in Gillian barre

A
  • NCS
  • EMG
  • Vital Capacity monitoring

(anti-GQ1b - for miller fisher)

32
Q

What phenomenon is seen on CSF in Gullian Barre

A

Albumincytologic dissociation

33
Q

What is albuminocytologic dissociation in Gullian Barre

A
  • Raised albumin

- Normal WCC

34
Q

Explain conduction velocity in GBS

A

Decreased

35
Q

What needs to be monitored in GBS

A

Vital Capacity

36
Q

How is GBS managed

A

IVIg

37
Q

What is ineffective in GBS

A

Glucocorticoids

38
Q

What is complication of GBS

A

Respiratory Failure

Neurology (26 decks)

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