Muscle and Nerve Diseases Flashcards
How do muscle diseases usually present ?
- Pain
- Cramping
- Weakness
- Atrophy
- Difficulty swallowing or breathing
- Stiffness
- Hypertrophy
How should you investigate Muscle disease ?
- EMG
- Bloods - Look at CK levels
- Muscle Biopsy - Structure, Biochemistry and Inflammation
- Genetic Testing
Name 3 congenital muscle diseases
- Muscular dystrophies
- Channelopathies
- Energy (mitochondria/enzymes)
Name 1 squired muscle disease
- Inflammatory muscle disease
How do we detect and treat muscle dystrophies ?
High CK levels. No specific treatment
What are channelopathies ?
Disorders of the Ca 2+, Na +, K + and Cl - ion channels
What symptoms do patients present with who have channelopathies ?
- Myotonia (delayed contraction)
- Periodic paralysis
What is the treatment of channelomyopathies ?
- Immunosuppression
- Physiotherapy
When discussing energy production muscle diseases how do we differentiate between problems in carbohydrate metabolism and lipid metabolism ?
If the fatigue/pain happens early on when exercising or later on.
What is the treatment for energy production muscle diseases ?
Diet modifications
Supplements
What are the two types of inflammatory muscle disease ?
Polymyositis and Dermatomyositis
Out of Polymyositis and Dermatomyositis which one present with a rash ?
DM
What can we see on investigations ?
CK high due to muscle damage and autoantibodies are present. CD8 present in PM and CD4 in DM.
What should be done in DM ?
Tumour screen
What is the treatment for inflammatory muscles disease ?
Immunosuppression
How will a patient with Myasthenia Gravis present ?
- Fatiguable weakness
- Ptosis
- Diplopia
What investigations should be done in someone suspected of having Myasthenia Gravis and what will show ?
- CT Chest to look for Thymoma
- EMG
- Bloods - Anti musk and AchR antibodies
How do you treat Myasthenia Gravis ?
- Acetylcholinesterase inhibitors
- Immunosuppression - Prednisolone
- Steroid saving agent
- Thymectomy may be needed
- Plasma exchange
What are the causes of generalised neuropathy ?
- Chronic alcoholism
- HIV
- Drug overdose
- Diabetes
How does generalised neuropathy begin and develop ?
Starts distally and works proximally
How do we investigate generalised neuropathy ?
- Bloods
- EEG/EMG
- Genetic testing
- Nerve biopsy
How do we treat generalised neuropathy ?
Treat the cause.
What causes Gullian-Barre syndrome ?
Thought to be linked to a problematic immune system usually triggered by a vaccine or infection.
How does Gullian-Barre syndrome present ?
Pain, weakness and numbness of the hand, feet and limbs.
Definition of myelopathy
Injury to the spinal cord
Definition of radiculopathy
Injury to the nerve roots
How does MND present ?
- Absent reflexes
- Flaccidity
- Decreased tone
- No sensory involvement
- May cause problems with swallowing/breathing
What is the treatment of MND ?
Supportative measures e.g. Erectile dysfunction, constipation, nutrition, depression.
What drug delays the need for ventilation in some people ?
Riluzone
