Muscle and nerve disease

Question 1

What is the presentation of muscle disease?

Answer 1

Pure motor signs
No sensory signs
Weakness of skeletal muscle
Cardiac symptoms
Cramps
Stiffness
Myoglobinuria

Question 2

What are some examples of muscular system diseases?

Answer 2

Polymyositis
Dermatomyositis
Muscular dystrophy
Myasthenia gravis
Amyotrophic lateral sclerosis
Cardiomyopathy

Question 3

What are the types of autoimmune inflammatory muscle disease?

Answer 3

Polymyositis
Dermatomyositis

Question 4

What are the features of autoimmune inflammatory muscle disease?

Answer 4

Acute or subacute
High CK
Autoantibodies
Tumours screen- Dermatomyositis is paraneoplastic

Question 5

What is the treatment of autoimmune inflammatory muscle disease?

Answer 5

Immunosuppression

Question 6

What kind of disorder is myasthenia gravis?

Answer 6

NMJ disease

Question 7

What is the main feature of myasthenia gravis?

Answer 7

Fatiguable muscle weakness

Question 8

What are the 2 forms of myasthenia gravis?

Answer 8

Ocular form
Generalised form

Question 9

What are the features of the ocular form of myasthenia gravis?

Answer 9

Ptosis
Diplopia

Question 10

What are the features of the generalised form of myasthenia gravis?

Answer 10

Many muscle groups
Limbs
Bulbar
Breathing
Swallowing

Question 11

What is associated with myasthenia gravis?

Answer 11

Abnormal enlargement or tumour of thymus gland

Question 12

What is the treatment of myasthenia gravis?

Answer 12

Cholinesterase inhibitors
Immunoglobulin/plasma exchange
Steroids
Steroid sparing immunosuppression

Question 13

What are the causes of peripheral neuropathy?

Answer 13

Root disease: degenerative disc disease
Lesion of individual peripheral nerve: compressive neuropathy, vasculitis
Generalised peripheral neuropathy

Question 14

What are the causes of generalised peripheral neuropathy?

Answer 14

Hereditary
Metabolic: diabetes, alcohol, vitamin deficiency
Toxic: drugs
Infectious: lyme disease, HIV
Malignancy
Autoimmune:
- Acute: Guillain Barre syndrome
- Chronic: chronic inflammatory demyelinating polyneuropathy (CIDP)

Question 15

What is Guillan Barre syndrome?

Answer 15

A rapid-onset muscle weakness caused by the immune system damaging the peripheral nervous system.
Causes weakness and tingling in arms and legs

Question 16

What is CIDP?

Answer 16

Inflammation of nerve roots and peripheral nerves and destruction of the myelin sheath

Question 17

What are the symptoms of peripheral neuropathy?

Answer 17

Sensory: loss/abnormal sensation, pain
Motor: muscle thinning, weakness
Autonomic: skin changes, postural hypotension, bowel/bladder dysfunction

Question 18

What are the signs of peripheral neuropathy?

Answer 18

Sensory: reduced sensation of light touch, pinprick, temperature, joint position and vibration sensation
Motor: LMN signs

Question 19

What is the other name for motor neuron disease?

Answer 19

Amyotrophic lateral sclerosis

Question 20

What are the features of motor neuron disease?

Answer 20

UMN signs: spasticity, brisk reflexes, extensor plantars
LMN signs: wasting, fasciculations, weakness, flexor plantars, flaccidity
No sensory involvement

Question 21

What is the treatment of motor neuron disease?

Answer 21

Supportive
Glutamate antagonist e.g. Riluzole
Palliative care