Neuropathy Flashcards

1
Q

Definition of mononeuropathy

A

Lesions of individual nerve

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2
Q

Causes of mononeuropathies

A

Local trauma

Entrapment eg. tumour

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3
Q

Mononeuritis multiplex definition

A

2 or more peripheral nerves affected

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4
Q

Mononeuritis multiplex general cause

A

Tends to be systemic

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5
Q

Specific causes of mononeuritis multiplex

WARDS PLC

A

Wegener’s

Aids / Amyloid

Rheumatoid

DM

Sarcoidosis

Polyateritis nodosa

Leprosy

Carcinomatosis

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6
Q

Median nerve muscle innervation

A

LOAF

2 Lumbricals

Opponens pollicis

Abductor pollicis brevis

Flexor pollicis brevis

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7
Q

Median nerve roots

A

C6-T1

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8
Q

Ulnar nerve roots

A

C7-T1

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9
Q

Sx of ulnar nerve neuropathy

A

Weakness / wasting of:

  • medial wrist flexors
  • interossei
  • hypothenar eminence

Sensory loss over medial 1.5 fingers

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10
Q

Rx of ulnar nerve neuropathy

A

Rest

Night time soft elbow splint

Surgery

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11
Q

Most common cause of ulnar nerve palsy

A

Cubital tunnel syndrome

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12
Q

Most common cause of median nerve palsy

A

Carpal tunnel syndrome

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13
Q

Sx of carpal tunnel syndrome

A

Pain in hand worse at night

Numbess in thumb and lateral 2.5 fingers

Phalen’s test

Tinel’s test

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14
Q

Rx of carpal tunnel syndrome

A

Splinting

Local steroid injection

Decompressive surgery

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15
Q

Radial nerve roots

A

C5-T1

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16
Q

Sx of radial nerve neuropathy

A

Wrist drop

Numbness over anatomical snuffbox

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17
Q

Muscles innervated by radial nerve

A

BEST

Brachioradialis

Extensors

Supinator

Triceps

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18
Q

Presentation of upper brachial plexus injury

A

Erb’s palsy

(Waiter’s tip)

Can’t abduct arm

Can’t flex elbow

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19
Q

Presentation of lower brachial plexus injury

A

Klumpke’s palsy

(Claw hand)

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20
Q

Phrenic nerve roots

A

C3, 4, 5

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21
Q

Sciatic nerve roots

A

L4-S3

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22
Q

Lateral cutaneous nerve of the thigh roots

A

L2-L3

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23
Q

Lateral cutaneous nerve of the thigh neuropathy presentation

A

Lateral burning thigh pain

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24
Q

Site of Lateral cutaneous nerve of the thigh entrapment

A

Inguinal ligament

25
Q

Common peroneal nerve roots

A

L4-S1

26
Q

Common causes of common peroneal nerve neuropathy

A

Trauma to fibular head

Sitting cross legged

27
Q

Common peroneal nerve palsy presentation

A

Foot drop

Sensory loss over dorsum of foot

28
Q

Tibial nerve roots

A

L4-S3

29
Q

Presentation of tibial nerve neuropathy

A

Can’t plantar flex

Can’t flex toes

Sensory loss over sole of foot

30
Q

Polyneuropathy definition

A

Symmetrical, widespread disorder of nerves

31
Q

Metabolic causes of polyneuropathy

A

DM

Renal failure

Hypothyroidism

32
Q

Malignancy causes of polyneuropathy

A

Paraneoplastic syndromes

Polycythaemia rubra vera

33
Q

Inflammatory causes of polyneuropathy

A

Guillain Barre syndrome

Sarcoidosis

34
Q

Inherited causes of polyneuropathy

A

Charcot-Marie-Tooth syndrome

35
Q

Infective causes of polyneuropathy

A

Leprosy

HIV

Syphillis

Lyme disease

36
Q

Toxin causes of polyneuropathy

A

Lead poisoning

Arsenic poisoning

37
Q

Drug causes of polyneuropathy

A

Alcohol

Isoniazid

Phenytoin

38
Q

Nutritional causes of polyneuropathy

A

Low B1

Low B12

Low folate

39
Q

DM polyneuropathy

A

Mostly sensory

Glove and stocking

40
Q

Another name for Charcot-Marie-Tooth syndrome

A

Peroneal muscular atrophy

41
Q

Genetics of Charcot-Marie-Tooth syndrome

A

Autosomal dominant

Ch 17

42
Q

Presentation of Charcot-Marie-Tooth syndrome

A

Starts in puberty

Weak legs + foot drop

43
Q

Sx of Charcot-Marie-Tooth syndrome

A

Peroneal muscle atrophy

Hand and arm muscle atrophy

Weak legs

Foot drop

Variable sensory loss

44
Q

Classical appearance of peroneal muscle atrophy

A

Inverted champagne bottle appearance

45
Q

Other name for Guillain Barre syndrome

A

Acute inflammatory demyelinating polyneuropathy

46
Q

Presentation of Guillain Barre syndrome

A

Few weeks post infection

Symmetrical ascending muscle weakness

Progresses days-4wks

Then recovery begins

47
Q

Triggers for Guillain Barre syndrome

A

Campylobacter jejuni

CMV

Mycoplasma

VZV

HIV

48
Q

Pathology of Guillain Barre syndrome

A

Infection triggers antibodies which attack nerves

49
Q

Sx of Guillain Barre syndrome

A

Ascending muscle weakness

Sweating

Tachycardia

Arrhythmias

50
Q

Worry with Guillain Barre syndrome

A

Respiratory muscle involvement

51
Q

Features required for diagnosis of Guillain Barre syndrome

A

Progressive weakness in all 4 limbs

Areflexia

52
Q

Mx of Guillain Barre syndrome

A

IV immunoglobulin 5 days

Plasma exchange

No Steroids

53
Q

Prognosis of Guillain Barre syndrome

A

85% make near complete recovery

Complete paralysis still compatible with recovery

54
Q

General Mx of polyneuropathies

A

Rx cause

Foot care

Splint joints

IV immunoglobulin for GBS

Rx neuropathic pain

55
Q

Rx of neuropathic pain

A

Amitriptyline

Gabapentin

Pregabalin

56
Q

Types of autonomic neuropathy

A

Isolated sympathetic

Isolated parasympathetic

Part of generalised sensorimotor peripheral neuropathy

57
Q

Sx of autonomic neuropathy

A

Postural hypotension

Erectile dysfunction

Sweating

Constipation

Horner’s syndrome

58
Q

Causes of primary autonomic failure

A

Parkinson’s disease

Lewy body dementia

59
Q

Causes of secondary autonomic failure

A

DM

Amyloidosis