Exam 4 Neuropathy

Question 1

Mononeuropathy is?

Median nn neuropathy causes what?

Peroneal nn?

Ulnar nn?

Radial nn?

Answer 1

Pathology of one nn

Median (Most C) = carpal tunnel

Peroneal = foot drop

Ulnar = weak hand

Radial = wrist drop

Question 2

Mononeuropathy Multiplex is?

Answer 2

Pathology involving > 1 individual nn

e.g. DM

Question 3

Polyneuropathy is?

Answer 3

Pathology of distal nn distributions

Question 4

Types of Neuropathy pathology:

Mechanical?

Vascular?

Axonal degeneration?

Neuronal degeneration?

Demyelination?

Answer 4

Mechanical = compressed or entrapped

Vascular = venous dz/arterial occlusion causing nn ischemia

Axonal degeneration = result of DM

Neuronal degeneration = ALS

Demyelination = immune-mediated (guillian)

Question 5

Neurapraxia is?

Answer 5

Mechanical -> Compression of nn -> axon damage but NO nerve damage

e.g. arm falls asleep from laying on it

Question 6

Causes of Vascular Neuropathies? (3)

Presents in?

Answer 6

DM (small aa occlusion)
Polyarteritis Nodosa (necrosis of med/large vessels)
RA

Multiple nn distributions

Question 7

Causes of Axonal Neuropathies? (2)

Presents how?

Answer 7

DM (most C)
Chemo/Lead

Sensory&raquo_space; motor

DM = symm distal sensory loss in feet,
therm/vibratory goes first,
pain w/ any contact

Question 8

Neuronal Degeneration Neuropathy presentation?

Answer 8

Pure motor neuron degen

Prox and distal mm weakness/fasiculation
NO sensory defects

Question 9

Causes of Demyelinating Neuropathies?

Lab finding for all causes?

Answer 9

Acute (autoimmune) = Guillain-Barre
Chronic (inherited) = Charcot-Marie-Tooth

↑ protein in CSF

Question 10

Acute?

Subacute?

Chronic?

Answer 10

onset w/i few days

onset w/i 2-4 wks

onset > 1 mo

Question 11

Motor sxs/complaints? (4)

Answer 11

Weak (U focal)
Fatigue
Cramps
Twitches

Question 12

Sensory sxs? (5)

Answer 12

Numb
Pain
∆ of sensation (sharp/dull, light touch) U stocking/glove
Lost coordination
Hyporeflex

Question 13

Myopathy is?

Presentation?

Answer 13

Inflamm or degeneration of skeletal mm

Proximal motor weakness (neural is distal)
NO sensory/reflex loss

Question 14

Motor Neuron dz presentation?

Answer 14

Up and/or LowMN dys

NO sensory sxs

Question 15

B12 deficiency presentation?

Answer 15

symm distal sensory

symm proximal motor

Question 16

Neuropathy studies? (2)

Answer 16

Nerve Conduction (NCS)
Electromyography (EMG)

Question 17

Neuropathy labs? (7)

Answer 17

CBC
CK
Thyroid
B12/Folic acid
ESR
ANA
Toxins

Question 18

NCS/EMG findings:

Demyelination?

Axonal?

Mono?

Poly?

Answer 18

Demyelination = Slowed conduction velocity

Axonal = Denervation ∆s

Mono = Slowing of segment on one nn

Poly = Slowed conduction velocity on many nn

Question 19

Other tests:

Nerve bx when?

MM bx when?

Imaging when?

Answer 19

nn bx = inflamm

mm bx = myopathy

image = tumor

Question 20

Tx for DM-caused neuropathy?

Answer 20

Control glucose

TCA for pain

Question 21

Tx for Guillian-caused neuropathy?

Answer 21

Supportive

Steroids don’t help