Mononeuropathies Flashcards
Where does damage to the peroneal nerve occur?
Compression of the nerve at the lateral border of the knee
What is the clinical presentation of peroneal neuropathy?
Foot drop and weakness of foot eversion
Sensory loss of the dorsum of the foot and lateral border of the shin
Complete weakness around the ankle producing ‘flail foot’
What muscles does the peroneal nerve innervate?
Tibialis anterior, extensor digitorum and hallucis, peroneus longus and brevis
When is the sciatic nerve most commonly damaged?
As a complication of hip arthroplasty, prolonged lithotomy position, vasculitis and/or tumour
What is the most common presentation of sciatic neuropathy?
Muscle weakness around the ankle and weakness of the toes
Sensory loss in the entire foor and distal lateral leg, ankle jerk+/- internal hamstring reflex is diminished or absent on the affected side
When does femoral neuropathy arise?
As a complication of retroperitoneal haematoma, lithotomy positioning or hip dilocation. Surgeries around the hip area causes femoral neuropathy
What are clinical symptoms of femoral neuropathy?
Difficult knee extension, difficult hip flexion, sensory loss around anterior +/- medial leg, patellar reflex diminished. Usually self limiting
What is lateral femoral cutaneous neuropathy otherwise known as?
Meralgia paresthetica
How does meralgia paresthetica present clinically?
Numbness and parasthesia along the lateral thigh. Symptoms increase on standing or walking and are relieved by sitting
Knee reflex intact
Strength and tone are normal
How is lateral femoral cutaneous neuropathy diagnosed?
Electrodiagnosis is needed to rule out lumbar plexopathy, radiculopathy or femoral neuropathy
What is the management of lateral femoral cutaneous neuropathy?
Analgesica (NSAIDS and/or lidocaine path), local nerve blood for pain relief, avoidance of tight belts around the waist
How does radial nerve neuropathy arise?
Compression of the radial nerve along the spiral groove.
Most common cause is trauma, but rarely infections and inflammation cause radial nerve palsy
How does radial nerve damage present clinically?
Wrist drop
Sensory loss over the dorsum of the hand, particularly 1st web space
What muscles are affected in radial nerve neuropathy?
Weakness of brachioradialis, extensor carpi radialis, extensor carpi ulnaris, extensor digitorum or extensor pollicis
How does ulnar radiopathy at the elbow arise?
Compression of the ulnar nerve around the elbow
Most commonly due to trauma
What is the clinical syndrome of ulnar radiopathy at the elbow known as?
Cubital tunnel syndrome
What are clinical symptoms of ulnar radiopathy at the elbow?
Weakness of the flexor carpi ulnaris, dorsal interossei and palmar interossei
Weakness of the hypothenar muscles,
Sensory loss along half of the 4th finger and little finger
Pain and weakness at the elbow
Parasthesia and numbness over medical hand, half of the 4th and entire little finger
How does median neuropathy arise?
Compression of the medial nerve under transverse carpal ligament
Causes include pregnancy, obesity, hypothyroidism, RA or occupational disease (eg long typing hours, prolonged use of screwdrivers)
What is medical neuropathy otherwise known as?
Carpal tunnel syndrome
What are the clinical symptoms of medial neuropathy?
Weakness of the 1st and 2nd lumbricals, opponens pollicis brevis, abductor pollicis brevis and flexor pollicis brevis
Sensory loss in tumb, forefinger, middle finger or half of ring finger
Initial presentation includes weakness and or burning sensation over the wrist
How does damage to the anterior interosseous nerve present?
Weakness of long flexors of the thumb and index finger. Unable to pronate foreaem. No sensory loss
The anterior interosseous nerve is a branch of which nerve?
The median nerve
