neuropathies

Question 1

are axonal or demyelinating neuropathies more common?

Answer 1

axonal

Question 2

Polyneuropathy

Answer 2

specific term that refers to a generalized, relatively homogeneous process affecting many peripheral nerves

Question 3

most common hereditary neuropathy?

Answer 3

Charcot-marie-tooth (CMT)

• demyelinating
• onion bulb

Question 4

polyneuropathy is characterized by…

Answer 4

• symmetric sensory loss
• burning
• pins and needles
• weakness

Question 5

chronic axonal polyneuropathy presentation:

Answer 5

Progressive sensory loss and dysesthesia (eg, numbness)
Burning sensations in the hands and feet
Mild gait abnormalities
With disease progression, weakness in legs and hands occurs
Wasting of leg muscles
Increases the risk of falling
Causes the classic “stocking and glove” distribution of sensory loss
With disease progression
Sensory loss ascends and increases in severity
Sensory loss can lead to injury and infection

Question 6

Charcot arthropathy clinical presentation:

Answer 6

One consequence of chronic peripheral neuropathy unique to DM
Caused by repeated microfractures of foot bones
Do not heal well
Progresses slowly over many years
Patients initially present with foot swelling
Classic presentation of advanced disease is “rocker-bottom foot”
May have other prominent bony features

Question 7

demyelinating polyneuropathies clinical presentation

Answer 7

Primarily GBS
Presentation is distinct from the axonal polyneuropathies
Primarily affect motor neurons
Weakness (rather than sensory loss) is an early sign of the disease
Wasting of the lower leg or feet muscles can occur
Patients eventually complain of distal dysthesias
Gait symptoms and clumsiness occur secondarily to reduced proprioception

Question 8

inflammatory polyneuropathy clinical presentation

Answer 8

Weakness and generalized sensory loss often occur together in patients with chronic inflammatory polyneuropathies

Question 9

hereditary polyneuropathy clinical presentation

Answer 9

Characteristically known as Charcot-Marie Tooth (CMT)
Do not typically complain of paresthesias or pain
The disease is slow and progressive
Neurologic deficits and atrophy are not easily discernable
Have a variable phenotype
Produces distal wasting and ‘inverted champagne bottle’ or ‘stork’ legs

Question 10

Diagnostic criteria for trigeminal neuralgia:

Answer 10

A. At least 3 attached of unilateral facial pain fulfilling criteria B and C
B. Pain includes
Recurring in paroxysmal attacks lasting from a fraction of a second to 2 minutes
Sever intensity
Electric shock-like, shooting, stabbing, or sharp in quality
At least 3 attacks precipitate by innocuous stimuli to the affected side of the face
C. No clinically evident neurologic deficit
D. Not better accounted for by another ICHD-03 diagnosis

Question 11

diagnosis of bells palsy:

Answer 11

Diffuse facial nerve involvement manifested by paralysis of facial muscles
With or without loss of taste on anterior 2/3 of tongue and altered secretion of lacrimal and salivary glands
Onset is acute
Over a 1 to 2 days
Progressive course, reaching maximal clinical weakness/paralysis with 3 weeks
Recovery to some degree within 6 months

Question 12

bells palsy tx:

Answer 12

prednisone