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Y4R3 - Medicine II 🩺 > L5: Peripheral Neuropathy > Flashcards

L5: Peripheral Neuropathy Flashcards

1
Q

Anatomy of PNS

A
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2
Q

Function of PNS

A
  • Carry impulses to & from the CNS.
  • These impulses regulate motor, sensory and autonomic activities.
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2
Q

Def of Peripheral Neuropathy

A
  • Neuropathy is an inflammation or degeneration of the peripheral and / or cranial nerves → impairment of conduction along these nerves → motor, sensory and / or autonomic manifestations.
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3
Q

Classification of Peripheral Neuropathy

A
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4
Q

Mononeuropathy

A

affection of & single nerve trunk in one limb

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5
Q

Mononeuropathy Multiplex

A

affection at more than one nerve trunk in the same limb

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6
Q

Polyneuropathy

A

affection of dore than one nerve trunk in more thair one limb

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7
Q

Causes of Mononeurpathy & Mononeuropathy Multiplex

A
  • Traumatic
  • Infective
  • Vascular
  • Metabolic
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8
Q

Causes of Mononeurpathy & Mononeuropathy Multiplex

  • Traumatic
A
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9
Q

Causes of Mononeurpathy & Mononeuropathy Multiplex

  • Infective
A
  1. Leprosy
  2. Herpes Zoster
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10
Q

Causes of Mononeurpathy & Mononeuropathy Multiplex

  • Vascular
A

Polyarteritis Nodosa

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11
Q

Causes of Mononeurpathy & Mononeuropathy Multiplex

  • Metabolic
A

DM

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12
Q

Causes of Polyneuropathy

A
  • Heredofamilial
  • Acquired
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13
Q

Causes of Polyneuropathy

  • Heredo-Familial
A
  • Peroneal muscle atrophy.
  • Hypertrophic interstitial polyneuropathy.
  • Refsum disease.
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14
Q

Causes of Polyneuropathy

  • Acquired
A
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15
Q

Acquired Causes of Polyneuropathy

  • Infective
A
  • Viral: mumps, measles.
  • Bacterial: Typhus, Typhoid, Tetanus.
  • Mycobacterial: Leprosy.
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16
Q

Acquired Causes of Polyneuropathy

  • Toxic
A
  • Inorganic: lead, copper, arsenic, antimony, gold. (Heavy metals).
  • Organic: alcohol, insecticides.
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17
Q

Acquired Causes of Polyneuropathy

  • Metabolic & Endocrine
A

Diabetes mellitus, uremia, amyloidosis, acromegaly, myxedema.

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18
Q

Acquired Causes of Polyneuropathy

  • Nutritional
A

Pellagra, Beri-Beri, subacute combined degeneration.

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19
Q

Acquired Causes of Polyneuropathy

  • Iatrogenic
A

Isoniazid, sulphonamides, phenytoin, vincristine.

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20
Q

Acquired Causes of Polyneuropathy

  • Autoimmune
A

Guillain Barre Syndrome, collagen vascular disorders.

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21
Q

Acquired Causes of Polyneuropathy

  • Paraneoplastic
A

Bronchogenic carcinoma, lymphoma.

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22
Q

Pathology of Axonal Neuropathy

A
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23
Q

Pathology of Demyelinating Neuropathy

A
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24
Q

CP of Polyneuropathy

  • General
A
  • Bilateral
  • Symmetrical
  • Distal more than Proximal
  • Lower Limbs earlier than Upper Limbs.
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25
Q

CP of Polyneuropathy

  • Sensory
A
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26
Q

CP of Polyneuropathy

  • Motor
A
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27
Q

CP of Polyneuropathy

  • Autonomic
A
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28
Q

Investigations for Polyneuropathy

A
29
Q

Investigations for Polyneuropathy

  • NCS
A
  • Reduced nerve conduction velocity
30
Q

Investigations for Polyneuropathy

  • Nerve Bx
A
  • usually the Sural Nerve
31
Q

Investigations for Polyneuropathy

  • Detect the cause
A
  • Blood sugar
  • Tests for collagen vascular disorders
  • S. creatinine
32
Q

Types of Diabetic Neuropathy

A
  • Diabetic Sensorimotor Polyneurtopathy
  • Diabetic Autonomic Neuropathy
  • Diabetic Proximal Neuropathy (Diabetic Amyotrophy)
  • Diabetic Mononeuropathy
  • Diabetic Truncal Neuropathy
33
Q

Diabetic Sensorimotor Polyneuropathy is common in

A

Type I DM

34
Q

CP of Diabetic Sensorimotor Polyneuropathy

A
35
Q

Pathogenesis of Diabetic Sensorimotor Polyneuropathy

A
  • Hyperglycemia will cause sorbitol accumulation → decreased myoinositol uptake by nerve Fibers —-> impaired impulse conduction.
36
Q

CP of Diabetic Autonomic Polyneuropathy

A
  • Sweating
  • Diarrhea
  • Postural hypotension
  • Impotence.
37
Q

Another Name of Diabetic Proximal Polyneuropathy

A

Diabetic Amyotrophy

38
Q

Diabetic Proximal Polyneuropathy is common in ……

A

Type II DM

39
Q

CP of Diabetic Proximal Polyneuropathy

A
40
Q

CP of Diabetic Mononeuropathy

A
41
Q

CP of Diabetic Truncal Neuropathy

A
  • Recurrent attacks of truncal pain with sensory deficit in the distribution of a single thoracic root.
  • Spontaneous recovery occurs in few months..
42
Q

TTT of Diabetic Neuropathy

A
43
Q

Another Name of Peroneal Muscle Atrophy (BMSN)

A

Charcot-Marie-Tooth Disease

44
Q

Compare between Type I,II,III Peroneal Muscle Atrophy (BMSN)

  • Incidence
  • Inheritance
  • Age
  • CP
A
45
Q

Compare between Type I,II,III Peroneal Muscle Atrophy (BMSN)

  • Incidence
  • Inheritance
  • Age
  • CP
A
46
Q

Compare between Type I,II,III Peroneal Muscle Atrophy (BMSN)

  • Incidence
  • Inheritance
  • Age
  • CP
A
47
Q

Compare between Type I,II,III Peroneal Muscle Atrophy (BMSN)

  • Incidence
  • Inheritance
  • Age
  • CP
A
48
Q

Compare between Type I,II,III Peroneal Muscle Atrophy (BMSN)

  • Incidence
  • Inheritance
  • Age
  • CP
A
49
Q

TTT of Peroneal Muscle Atrophy (BMSN)

A
  1. Physiotherapy.
  2. Ankle splints for foot drop.
50
Q

CP of Diphtheritic Neuropathy

A
  1. Starts by true bulbar palsy (within few days).
  2. Paralysis of eye accommodation (ciliary muscle paralysis ) > blurred near vision.
  3. Generalized sensorimotor polyneuropathy.
  4. Diaphragmatic paralysis.
51
Q

Prognosis of Diphtheritic Neuropathy

A
  • Good if the child survives.
  • Bulbar & accommodation weakness improve within 6 weeks.
  • Polyneuropathy recovery takes months.
52
Q

TTT of Diphtheritic Neuropathy

A
  • Penicillin G: 600,000 u/12 hours for 14 days.
  • Diphtheritic antitoxin: should be given early as 100,000 u IM.
  • Assisted ventilation if need.
53
Q

Organism Causing Leprotic Neuropathy

A

Mycobacterium leprae

54
Q

IP in Leprotic Neuropathy

A

Long Incubation period (about 3.5 years) with Insidious onset.

55
Q

Types of Leprotic Neuropathy

A
56
Q

CP of Leprotic Neuropathy

A
57
Q

TTT of Leprotic Neuropathy

A
  1. Dapsone 100mg/day + Rifampicin 600 mg/ day (for 1 -2 years).
  2. Nerve grafting for severe mononeuropathy with trophic ulcers.
57
Q

Another Name of Guillian-Barre Syndrome

A

Acute Post Infective Polyradiculoneuropathy

58
Q

Etiology of Guillian-Barre Syndrome

A
59
Q

CP of Guillian-Barre Syndrome

A
60
Q

CP of Guillian-Barre Syndrome

  • Motor
A
61
Q

CP of Guillian-Barre Syndrome

  • Sensory
A

Glove and stocking hypoesthesia

62
Q

Prognosis of Guillian-Barre Syndrome

A
  • Recovery in 3-6 months.
  • May be with mild residue in 40% of cases.
  • Survival for 8 weeks carries a good prognosis.
63
Q

Investigations for GBS

A
64
Q

TTT of GBS

A
65
Q

TTT of GBS

  • NGT
A

feeding for bulbar palsy.

66
Q

TTT of GBS

  • Assissted Ventilation
A

…

66
Q

TTT of GBS

  • SC Heparin
A

to guard against deep venous thrombosis (DVT).

67
Q

TTT of GBS

  • Plasmapheresis
A

must be done in the first 2 weeks

68
Q

TTT of GBS

  • IVIG
A

0.4 g/Kg / day for 5 successive days.

Y4R3 - Medicine II 🩺 (16 decks)

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