Lecture 3: Peripheral Neuropathies Flashcards
Should peripheral neuropathy conditions have UMN/CNS signs?
NOOOO!!!!!
What are the disease/conditions in this lecture?
GBS, CIDP, Diabetes neuropathy
PNS motor symptoms
- hypo- or areflexic
- Hypotonic
- Weakness
- fasciculations
PNS sensory symptoms
- cutaneous nerve loss
- stocking glove pattern loss
- dermatomal pattern loss
PNS autonomic symptoms
- flushing (redness)
- Change in HR, SOB, BP
- Incontinence, constipation, diarrhea
- Dry eyes, mouth
Are extra ocular cranial nerves affected in peripheral neuropathies; PNS conditions?
YES, 3, 4, 6
What is the gold standard diagnostic test for peripheral neuropathies?
- EMG/NCV studies –> helps determine whether it is primarily axonal, demyelinating or mixed
GBS is also known as?
Acute inflammatory demyelinating polyneuropathy
is GBS autoimmune disease???
YES , because the immune system attacks myelin sheath
Where does GBS fall on the recovery compensation scale?
IN THE MIDDLE, there is potential recover for GBS !!! unlike ALS, MG, DMD
What are RED FLAGS for these PNS disorders?
UMN SIGNS and timeline
Signs and symptoms of GBS?
- initial N/T in hands and feet
- distal > proximal
- Symmetric weakness
- diminished DTRs
- autonomic dysfunction
diagnostic tests for GBS?
- MRI to r/o spinal cord
- EMG/NCV
- CSF studies
- Lumbar puncture
5 differential diagnosis for GBS?
- Acute spinal cord disease
- Brain stem ischemia
- MG
- Botulinium intoxication
- CIDP
NUMBER 1 MEDICAL MANAGEMENT OF GBS?
IVIG
4 indicators of poor prognosis for GBS?
- Older age
- Require vent support
- Rapid progression (< 7 days)
- Axonal injury
How long does GBS typically resolve?
1-2 years
how do clinical ID GBS?
- Areflexia/ diminished DTRs
- Symmetric weakness
- Strength deficits W/O sensory involvement
- NO UMN SIGNS
- pain/fatigue
During intervention of GBS, for a PT what should you monitor?
- Overwork weakness
WHAT IS THE KEY DISTINGUISHING FACTOR b/t GBS vs CIDP?
TIMELIN: CIDP symptoms onset happens much later…. > 2 months
How to clinical ID CIDP?
same as GBS, you just have to know timeline
what is the MOST common cause of neuropathy in US?
Diabetes Mellitus –> causing diabetic neuropathy
Pathogenesis of Diabetic Neuropathy?
- High blood glucose –> metabolic changes –> axonal destruction
Routine diagnostic tests for Diabetic Neuropathy…
- Glucose tolerance test
- EMG/NCV (sensory changes)
