507.- The opathies Flashcards
What are the signs of a bells palsy?
Abrupt onset facial weakness
numbness or pain around ear
reduced taste
hypersensitivity to sounds
What are the cuases of a bells palsy?
Idiotpathic, Pregnancy, diabetes
Ramsay hunt syndrome, lyme disease, TB, viruses
Stroke, tumour, MS,
Accousin neuroma
LYME DISEASE, G.B., SARCOID- bilateral
What is the treatment of bells palsy?
Look for cause
Pred- 72 hours
No role for aciclovir
Dark glasses and artifical tears
Surgery in extreme cases
What is ramsay hunt syndrome?
How is it treated?
Reactivated VZV in 7th cranial nerve
Aciclovir and prednisolone
What are the features of carpal tunnel syndrome?
Aching pain in hadn and arm
Paraethesia in thumb, index and middle finger
Weakness of abductor pollicus brevis
What are the signs of an ulnar nerve palsy?
Weakness of ulnar side of hand
Can’t do fingers crossed
Claw hand of 4th and 5th metatarsals
What are the cause of a branchial plexus injury?
Trauma
Radiotherpay
Heavy rucksack
Cervical rib
Thoracic outlet compression
What can cause a phrenic nerve palsy?
Lung cancer, TB, Paraneoplastic syndrome
Myeloma, Thyoma, cervical spondlyosis, thoracic surgery
Infection- HZV, HIV, Lymes
What nerve palsy causes meralgia paraethetica
Lateral cutaneous nerve of the thigh
What are the common mononeuropathies of the foot?
What syptoms do they cause?
Sciatic nerve- foot drop and no sensation on lateral below knee
Peroneal nerve damage- foot drop, sensory loss over dorsal foot
Tibial nerve- Cant stand on tiptoe. Can invert foot or flex toes. Sensory loss over sole
What is the management of a POLYNEUROPATHY (motor and/or sensory deficit of multipel regions)
Treat cause
Physio and OT
Foot care
Splint joints
IV immunoglobulin for guillian barre
Vasculitic/autoimmune- steroids or immunosuppresants
Neuropathic pain- gabapentin, preablan, amitryptilline, duloxetine
How do you differentiate between myopathy and neuropathy
Specific muscle groups
Gradual onset of symtpoms
No paraesthesiae
No fasciculations
Describe the symtpoms of duchenne’s muscular dystrophy
Presents at 4
Clumsy walking
Difficulty standing, respiratory failure
Raised serum CK
Describe the symtpoms of Becker’s muscular dystrophy
Same as duchenne’s but better prognosis
What is Facioscapularhumeral dystrophy?
12-14 years old, not as bad prognosis
Cant puff out cheeks
Raising hands above head
Scapular
