L8 Neuropathy Flashcards
what is peripheral neuropathy
refers to the conditions that result when nerves that carry messages to and from the brain and spinal cord from and to the rest of the body are damaged or diseased
what nerves does neuropathy affect
motor, sensory or autonomic
what is polyneuropathy
damage or disease affecting peripheral nerves (peripheral neuropathy) in roughly the same areas on both sides of the body, featuring weakness, numbness, and burning pain
what are features of polyneuropathy
- longest nerves most
- vulnerable (distal and symmetrical)
- nerves are trophic to muscle (muscle wasting)
- involved in reflex arc (reduced reflexes)
- sensory nerves similarly vulnerable (distal sensory loss)
what does NCS/EMG tell you
- if neuropathy is present
- if sensory, motor, mixed is involved
- what is the pattern: symmetry, length, focal/multifocal
- is pathology axonal or demyelinating
what are symptoms, signs, tests, and caveats when the motor part is involved in the PNS
symptoms: tripping, feet slapping, hand weakness
signs: distal weakness and wasting
tests: reduced amplitude of NCS, neurogenic EMG
caveats: apparent weakness from sensory loss
what are symptoms, signs, tests, and caveats when the sensory (small fibre) part is involved in the PNS
symptoms: numb feet, burns, ulcers (neuropathic pain)
signs: loss of vibration sensation (and pinprick)
tests: reduced amplitudes on sensory NCS (may be normal)
caveats: few symptoms in inherited
what are symptoms, signs, tests, and caveats when the autonomic part is involved in the PNS
symptoms: fainting, loss of sweating, impotence
signs: postural BP drop, loss of sweating
tests: autonomic function tests
how do you know if the neuropathy is acquired?
acute or sub acute monophasic or relapsing remitting exposure history asymmetrical adult onset positive sensory symptoms
how do you know if the neuropathy is inherited
longstanding progressive family history symmetrical childhood onset few sensory symptoms
what is charcot marie tooth disease?
group of inherited conditions that damage the peripheral nerves
does it affect sensory or motor of charcot marie tooth
how is it classified
what is its forms
both
classified according to neurophysiology. type 1: demyelinating, velocity <38m/s. type 2: axonal, conduction velocity >38m/s
forms: dominant, recessive, X-linked
what is the prevalence charcot marie tooth
how does it progress
1:2500
gradually progressive length dependant weakness and numbness
how many genes can cause charcot marie tooth disease, what therapy is available
over 60 different genes could cause it
no specific therapy exists, treatment trials are hampered by insensitive outcome measures
what is the clinical approach to neuropathy
does patient have neuropathy
what parts (autonomic,sensory,motor) or other organ systems involved
is it acquired or inherited
is it axonal or demyelinating