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Neurology > Mononeuropathies > Flashcards

Mononeuropathies Flashcards

1
Q

What is the most common cause of radial nerve palsy?

A

Entrapment at the spinal groove known as ‘Saturday night palsy’

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2
Q

Describe the presentation of radial nerve palsy

A

Wrist and finger drop
Usually painless
Weak wrist and finger extension
Weak elbow flexion in mid-pronation

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3
Q

Which muscles are weakened by a radial nerve palsy?

A

Extensor carpi radialis longus
Extensor diggitorum communis
Brachioradialis

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4
Q

What is the most common cause of ulnar nerve palsy?

A

Entrapment of the ulnar groove (medial epicondyle of humerus)

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5
Q

Ulnar nerve palsy is usually painful. T/F?

A

False - it is usually painless

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6
Q

Describe the presentation fo ulnar nerve palsy

A

Weak index finger abduction, wrist flexion and thumb adduction
Sensory disturbance

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7
Q

Which muscles are weakened by ulnar nerve palsy?

A

Dorsal interosseous
Abductor digits minimis
Flexor carpi ulnaris
Adductor pollicus

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8
Q

What is the most common cause of median nerve palsy?

A

Entrapment within the carpal tunnel at the wrist

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9
Q

Describe the presentation of median nerve palsy

A

Intermittent nocturnal pain
Numbness and tingling, often relieved by shaking of the hand
Weak grip
Positive tinels or phalen’s test

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10
Q

What is the most common cause of median nerve II anterior interosseous branch palsy?

A

Trauma to the forearm

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11
Q

Describe the presentation of median nerve II anterior interosseous branch palsy?

A

History. of forearm pain

Patient may complain of ‘weak grip’ of keys

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12
Q

What is the most common cause of femoral nerve palsy?

A

Haemorrhage

Trauma

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13
Q

Describe the presentation of femoral nerve palsy?

A

Weak knee extension, hip flexion and numbness in medial shin

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14
Q

What is the most common cause of peroneal nerve palsy?

A

Entrapment of the fibular head

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15
Q

Describe the presentation of common peroneal nerve palsy?

A

History of trauma, surgery or external compression
Acute onset of foot drop and sensory disturbance
Painless

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16
Q

What are the common causes of mono neuritis multiplex?

A 
Diabetes
Vasculitis - polyarteritis nodosa
Rheumatological - RA, lupus, sjogre's syndrome
Infective - hep c, HIV
Sarcoidosis
Lymphoma
17
Q

What signs/symptoms occur in large myelinated sensory fibre neuropathy?

A

Sensory ataxia
Loss of vibration sense
Possible: numbness and tingling

18
Q

What signs/symptoms occur in large myelinated memory fibre neuropathy?

A

Weakness

Muscle atrophy

19
Q

What signs/symptoms occur in small thinly myelinated or unmyelinated sensory fibre neuropathy?

A

Impaired pin prick response / temperature sensation

Painful burning, numbness and tingling

20
Q

What signs/symptoms occur in autonomic neuropathy?

A

Postural hypotension
Erectile dysfunction
GI disturbance
Abnormal sweating

21
Q

Describe the presentation of length dependent axonal neuropathy?

A

Occurs in patients >50 years

Diffuse involvement of peripheral nerves which is symmetrical and slowly progressive with no significant sensory ataxia

22
Q

What are the possible causes of length dependent axonal neuropathy>

A 
Diabetes
Alcohol
Folate/B12/thiamine/B6 deficiency
RA, lupus, vasculitis,
Renal failure, hypothyroidism
Drugs
HIV, hep B/C
Charcot Marie tooth
Myeloma
Paraneoplastic
Critical illness
23
Q

Guillain Barre syndrome occurs post-infection. Which infections can commonly result in GBS?

A

Campylobacter
CMV
EBV

24
Q

Describe the presentation of Guillain barre syndrome?

A

Progressive ascending weakness over a period fo days
Flaccidity
Quadraparesis
Areflexia
Possible respiratory, bulbar, autonomic involvement

25
Q

How is Guillain barre syndrome treated?

A

IV immunoglobulin or aphaeresis

26
Q

What is the chronic form of Guillain barre syndrome?

A

CIDP

27
Q

What are the possible symptoms of muscle disorders?

A

Proximal limb weakness - difficulty raising arms above head, arising from a seated position
Facial weakness - characteristic myopathic faces, drooling
Eyes - ptosis, ophthalmoplegia
Bulbar - dysarthria, dysphagia
Neck and spine - head drop, scoliosis
Respiratory - breathlessness
Myocardial - exercise intolerance, palpitations

28
Q

What are the possible causes of muscle disease?

A 
Muscular dystrophies
Metabolic muscle disorders (glycogen storage diseases, defects of fatty acid metabolism)
Mitochondrial disorders
Myotonic dystropies
Inflammatory muscle disorders
Neuromuscular junction disorders
29
Q

Describe the pathogenesis of myasthenia gravis?

A

Autoimmune disorder in which antibodies bind to and block the ACH receptor at the post synaptic neuromuscular junction

30
Q

What other conditions is myasthenia gravis associated with?

A

Autoimmune disorders
Thymus hyperplasia
Thymoma

31
Q

What age groups are typically affected by myasthenia gravis?

A

Women in their 20s

Older men in their 70s

32
Q

What are the symptoms of myasthenia gravis?

A

Fatiguable weakness of ocular, bulbar, neck, respiratory and/or limb muscles

33
Q

How is myasthenia gravis managed?

A

Pyridostigmine (anti-ACH esterase)

Immunosuppressive therapies such as steroids, IV immunoglobulins

Neurology (10 decks)

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