NMD of Peripheral Nerves Flashcards
discuss CMT
hereditary motor and sensory neuropathy - HMSN
slow progressive distal to proximal weakness of LE then UE
sensory affected
most common inherited peripheral neuropathy
CMT
clinical features of CMT
distal muscle weakness and atrophy of foot and hand intrinsics and LE -> UE -> knee/elbow -> girdle
impaired sensation
are or hyporeflexia
foot drop or steppage gait
pes cavus, claw hand and inverted champagne bottle
diff of fine motor tasks
impaired proprioception
scolio in later stages
types of CMT
CMT 1: demyelinating; dominantand manifests as it grows
CMT 2: axonal; dominant and manifests as it grows
CMT 3: baby is born with it; dominant/recessive
CMT 4: recessive and mix of axonal or demyelinating
CMT X: males only
diagnosis of CMT
enlargement of nerve - onion bulb
EMG-NCV
genetic testing
nerve biopsy
what are toxic neuropathies
rare
exposure to heavy metals and environmental toxins
discuss arsenic polyneuropathy
from pesticides
sensorimtor - axonal degeneration
mee’s lines
discuss lead polyneuropathy
from chipping paint then kainin
motor only
discuss mercury encephalopathy
from thermometer or BP na basag
motor only
discuss organophosphate poisoning
insecticides
discuss glue sniffing
from rugby - teenagers
discuss GBS
autoimmune polyneuropathy following infection
MC cause of non-inherited progressive flaccid paralysis
MEN
15-35 or 50-75 yo
cause of GBS
GI - campylobacter jejuni
respiratory - cytomegalovirus
recent surgery, SLE, stress, weak immune system
preceded by infection 1-3 prior to onset
ssx of GBS
glove and stocking dysesthesia
proximal then distal weakness that starts in LE
then arms, trunk, CN and respiration
sx peak by 12 days then progressively worsens
around 200 days of recovery 2-4 wks p progression stops
discuss prognosis for GBS
schwann cells lng damaged and not axon
2-3 wks after demyelination mg remyelinate na ule
