Chapter 27: Diseases of Peripheral Nerves Flashcards
Which painful nodule composed of non-neoplastic haphazard whorled proliferation of axonal processes and assoc. Schwann cells results from failure of axons to find their distal target during regeneration ?
Traumatic neuroma aka “pseudotumor”

What is the electrophysiologic hallmark of axonal neuropathies vs. demyelinating neuropathies?
- Axonal neuropthay = a reduction in signal strength
- Demyelinating neuropathy = slowed nerve conduction velocity
What are the primary targets of damage in demyelinating neuropathies?
Schwann cells w/ their myelin sheaths
Why is the peripheral nerve dysfunction caused by neuronopathies equally likely to affect proximal and distal parts of the body?
Damage at the level of neuronal cell body
Mononeuritis multiplex describes a disease process that damages several nerves in a haphazard fashion and is commonly due to what?
Vasculitis i.e., polyarteritis nodosum

Characteristic “stocking and glove” distribution of sensory deficits is seen with what anatomic pattern of peripheral neuropathies?
Polyneuropathies

Histologic features of Guillain-Barre Syndrome are characterized by what?
Inflammation** and **demyelination of spinal nerve roots and peripheral nerves = radiculoneuropathy

2/3’s of Guillain-Barre Syndrome cases are preceded by what; which etiologies have been implicated?
- Acute, influenza-like illness
- Campylobacter, CMV, EBV, and Mycoplasma penumoniae, or prior vaccination

Morphologically what is the most prominent lesion seen in Guillain-Barre Syndrome?
Segmental demyelination affecting peripheral nerves

Clinical presentation of Guillain-Barre Syndrome is dominated by what signs/sx’s; what characteristic CSF finding will there be?
- Ascending paralysis and areflexia
- DTR’s lost early in the process
- ↑ CSF protein levels w/ little or no CSF pleocytosis (inflammatory cells remain confined to the roots

How is Guillain-Barre Syndrome managed clinically?
Plasmapheresis and IV Ig

What is the most common acquired inflammatory peripheral neuropathy?
Chronic inflammatory Demyelinating Poly(radiculo)neuropathy

Chronic inflammatory Demyelinating Poly(radiculo)neuropathy is characterized by what type of neuropathy?
Symmetrical mixed sensorimotor polyneuropathy that persists for 2 months or more

Which 2 features of Chronic inflammatory Demyelinating Poly(radiculo)neuropathy distinguish it from Guillain-Barre?
Time course (presence at least 2 months) and response to steroids

How is Chronic inflammatory Demyelinating Poly(radiculo)neuropathy treated?
Glucocorticoids + IVIg + plasmapheresis
