Neuropathies Flashcards
What is a radiculopathy?
It is the compression of a spinal nerve root causing sensory disturbance and weakness in nerve root distribution. (Dermatome and mytome)
What are the nerve roots of the median nerve?
C6-T1
How does carpal tunnel present?
Compression of median nerve within carpal tunnel.
Loss of sensation over thumb, index, middle and lateral half of third finger.
Thenar wasting and weakness in grip strength.
Management of carpal tunnel syndrome?
Splitting, steroid injection, decompression surgery.
Ulnar nerve roots?
C7-T1
Cubital tunnel syndrome symptoms?
Sensory loss over medial 1.5 fingers.
Development of ulnar claw.
Hypothenar muscle wasting.
Management = surgical decompression.
Radial nerve roots?
C5-T1 (anatomy lecture states c6, c7,c8)
How does the radial nerve get damaged? What are the symptoms?
By compression or by humeral shaft fractures
Symptoms = wrist drop, loss of sensation over 1st dorsal web space.
Common fibular nerve / common peroneal nerve roots?
L4-S1
Common peroneal nerve damage symptoms?
Foot drop
Loss of sensation laterally below the knee and over the dorsum of the foot.
Tibial nerve damage symptoms?
Tibial nerve = L4-S3
Sensory loss over sole of food, weakness in plantar flexion (unable to stand on tip toes)
Sensory polyneuropathies normal present in which way?
Usually in a glove and stocking pattern with subsequent proximal spread.
What is Guillain barre syndrome?
An acute, autoimmune inflammatory demyelination get peripheral neuropathy.
How does Guillain Barre present?
Usually within a few weeks after an infection, especially upper respiratory and GI infections.
Ascending muscle weakness starting in lower limbs and spreading, usually over a 4 week period.
Accompanied by paraesthesia in the feet and hands.
Usually affects proximal muscles before distal muscles.
Paralysis is typically flaccid with arreflexia.
What does the LP show in Guillain barre?
Nerve conduction studies in Guillain barre?
It shows increased CSF protein with a normal cell count.
Slowing of nerve conduction velocities.
Management of Guillain barre?
IV IG
Plasmapheresis
+/- ventilatory support
What is Charcot Marie Tooth Disease?
How is it inherited?
It a hereditary sensory motor neuropathy
It is inherited in an autosomal dominant fashion.
Presentation of Charcot Marie tooth disease?
Begins around puberty.
Progressive distal muscle wasting in the legs giving rise to CHAMPAGNE shaped legs.
Associated lower limb weakness.
Foot drop and high stepping gait.
+/- sensory disturbance and loss of reflexes.
Management = Physiotherapy
Work up for peripheral neuropathy?
Bloods: FBC, UEs, LFT, TFTs, Glucose, B12/folate
Urinalysis
CXR
Lumbar puncture
Nerve conduction studies.
