Nerve Pathology Part 3 Flashcards
Median N entrapment will cause what syndromes?
Pronator Syndrome
Carpel Tunnel Syndrome
Anterior Interosseous Syndrome (motor)
Ulnar N entrapment will cause what syndromes?
Cubital Tunnel Syndrome
Tunnel of Guyon Syndrome
Radial N entrapment will cause what syndromes?
Radial Tunnel Syndrome
Posterior Interosseous Syndrome (motor)
What are the mechanical causes of carpel tunnel syndrome?
Overuse
RA/Tenosynovitis
Lipoma
Fx/Dislocations
What are the physiologic causes of carpel tunnel?
Diabetes
Hypothyroidism
Pregnancy
Symptoms of carpel tunnel syndrome include?
Wrist/Hand pain that may radiate to forearm, elbow, and shoulder
Other symptoms of carpel tunnel syndrome includes?
Numbness/paresthesias of radial 3 and 1/2 digits sparing the thenar eminence
Nocturnal Exacerbations
What are the physical examination tests for carpel tunnel syndrome?
Phalen's Tinel's or Compression Abductor Policis Brevis Weakness Objectifiable Sensory Loss over Radial 3 and 1/2 digits Eventual Thenar Atrophy
Electrodiagnostic studies for carpel tunnel syndrome shows what with NCV studies?
Latency
What is the term for entrapment or compression of the lateral femoral cutaneous nerve?
Meralgia Paresthetica
Sites of entrapment/compression for meralgia paresthetica include?
Inguinal Ligament
External Forces such as being overweight and sitting for long periods of time.
What N travels through a tunnel formed by the flexor retinaculum, calcaneus and distal tibia (malleolus)?
Posterior Tibial N
What syndrome is most often due to hyperpronantion which stretches the N in the tunnel?
Tarsal Tunnel Syndrome
How do you test for for tarsal tunnel syndrome?
Dorsiflexion and Eversion of the Ankle
What disease is extremely common and on the rise?
Diabetic Neuropathies
What causes diabetic neuropathies?
Deposition of sorbitol
Blockage of Vascular Supply
What are the different types of neuropathy?
Symmetric Distal
Asymmetric
Amyotropy
Autonomic
When a patient complains of bilateral leg weakness following either a viral infection or immunization the disease is known as?
Guillain-Barre Syndrome
A patient with guillain barre syndrome may complain of?
Distal Paresthesias
What’s the cause of Guillain-Barre syndrome?
Unknown, but believed to be a demyelinating autoimmune disorder.
What is the association with guillain barre syndrome?
Post-viral Illness
What are some of the symptoms for guillain barre syndrome?
Loss of deep tendon reflexes
Fluctuations in BP
Abnormalities in Sweating
Sphincter Dysfunction
With guillain barre syndrome the weakness will progress how?
Variably and involves arms and face
10% of patients with guillain barre syndrome have?
Respiratory Involvement
Patients with guillain barre syndrome demonstrate high protein content where?
CSF (may take 2-3 weeks)
Guillain-Barre syndrome is self-resolving in how many patients within months?
80%-90%
10% of patients with guillain barre syndrome will have what?
Residual Disability
What medication should not be given for guillain barre syndrome because of the possibility of prolonging recovery time?
Prednisone
What medication will benefit a patient with guillain barre syndrome?
Plasmapheresis
IV Immunoglobulin
Myastenia gravis involves what?
Neuromuscular Junction
What are the symtoms of myasthenia gravis?
Double Vision
Difficulty Swallowing
Weakness of the arm with repeated use
Weakness of jaw muscles when chewing
What is blocked by autoantibodies that bind to Ach receptors and makes them unavailable?
Neuromuscular Transmission
Myastenia Gravis may be idiopathic or associated with?
Thymoma, thyrotoxicosis, RA, or lupus
What are common in older men?
Thymomas
What is considered in a search for a thymoma?
Chest Radiograph
Computed Tomography
In an older man with thymoma electrophysiologic testing will reveal a decreased response to?
Stimulation
What lab tests are used to test for myasthenia gravis?
A test to assay circulating levels of Ach receptor antibodies
Medical evaluation for myasthenia gravis involves drug testing using a short acting anticholinesterase which causes?
Temporary Increase in Strength
Symptomatic treatment for myasthenia gravis involves the use of?
Anticholinesterase medications such as Neostigmine or Pyridostigmine
What is often dramatically effective and is often recommended to patients under age 60 years old with myasthenia gravis?
Thymectomy
What disease is idiopathic but 50% of them are associated with neoplasm?
Lambert-Eaton Syndrome
Lambert-eaton syndrome forms antibodies with?
Calcium
The antibodies prevent the opening of calcium channels and thus prevent the release of?
Acetylcholine
With lambert eaton, weakness is apparent immediately upon testing but improves on?
Sustained contraction
Lambert eaton doesn’t usually include?
Cranial Nerves
The treatment for lambert eaton is similar to the treatment for?
Myastenia Gravis
