Muscle and nerve disease Flashcards
What is the presentation of muscle disease?
Pure motor signs
No sensory signs
Weakness of skeletal muscle
Cardiac symptoms
Cramps
Stiffness
Myoglobinuria
What are some examples of muscular system diseases?
Polymyositis
Dermatomyositis
Muscular dystrophy
Myasthenia gravis
Amyotrophic lateral sclerosis
Cardiomyopathy
What are the types of autoimmune inflammatory muscle disease?
Polymyositis
Dermatomyositis
What are the features of autoimmune inflammatory muscle disease?
Acute or subacute
High CK
Autoantibodies
Tumours screen- Dermatomyositis is paraneoplastic
What is the treatment of autoimmune inflammatory muscle disease?
Immunosuppression
What kind of disorder is myasthenia gravis?
NMJ disease
What is the main feature of myasthenia gravis?
Fatiguable muscle weakness
What are the 2 forms of myasthenia gravis?
Ocular form
Generalised form
What are the features of the ocular form of myasthenia gravis?
Ptosis
Diplopia
What are the features of the generalised form of myasthenia gravis?
Many muscle groups
Limbs
Bulbar
Breathing
Swallowing
What is associated with myasthenia gravis?
Abnormal enlargement or tumour of thymus gland
What is the treatment of myasthenia gravis?
Cholinesterase inhibitors
Immunoglobulin/plasma exchange
Steroids
Steroid sparing immunosuppression
What are the causes of peripheral neuropathy?
Root disease: degenerative disc disease
Lesion of individual peripheral nerve: compressive neuropathy, vasculitis
Generalised peripheral neuropathy
What are the causes of generalised peripheral neuropathy?
Hereditary
Metabolic: diabetes, alcohol, vitamin deficiency
Toxic: drugs
Infectious: lyme disease, HIV
Malignancy
Autoimmune:
- Acute: Guillain Barre syndrome
- Chronic: chronic inflammatory demyelinating polyneuropathy (CIDP)
What is Guillan Barre syndrome?
A rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system.
Causes weakness and tingling in arms and legs
What is CIDP?
Inflammation of nerve roots and peripheral nerves and destruction of the myelin sheath
What are the symptoms of peripheral neuropathy?
Sensory: loss/abnormal sensation, pain
Motor: muscle thinning, weakness
Autonomic: skin changes, postural hypotension, bowel/bladder dysfunction
What are the signs of peripheral neuropathy?
Sensory: reduced sensation of light touch, pinprick, temperature, joint position and vibration sensation
Motor: LMN signs
What is the other name for motor neuron disease?
Amyotrophic lateral sclerosis
What are the features of motor neuron disease?
UMN signs: spasticity, brisk reflexes, extensor plantars
LMN signs: wasting, fasciculations, weakness, flexor plantars, flaccidity
No sensory involvement
What is the treatment of motor neuron disease?
Supportive
Glutamate antagonist e.g. Riluzole
Palliative care
