Peripheral Nerve Diseases Flashcards
define Guilain-Barré syndrome
an ascending inflammatory demyelinating polyneuropathy
causes of Guilain-Barré syndrome
often occurs in 1 - 3wks following either respiratory or GI infection
clinical features of Guilain-Barré syndrome
progressive ascending symmetrical limb weakness - begins in lower limbs sensory loss paraestherisae pain dysphasia + dysarthria
signs of Guilain-Barré syndrome
dysreflexia
hypotonia
papilloedema
bulbar palsy
investigations of Guilain-Barré syndrome
bloods (FBC, U+Es, LFTs and anti-ganglioside antibodies) ABG ECG spirometry MRI LP
findings in an LP of Guilain-Barré syndrome
normal white cell count + glucose and raised protein levels
conservative measures of Guilain-Barré syndrome
monitor ventilation
protect areas of potential pressure sore development
medical management of Guilain-Barré syndrome
IV immunoglobulin
plasmapharesis
DVT prophylaxis
defin Miller-Fisher syndrome
a similar disorder to Guilain-Barré syndrome but presents with triad of: ataxia, areflexia and opthalmoplegia
define multiple sclerosis (MS)
a chronic disease of the CNS
describe characteristics of MS
white plaque areas of demyelination and perivascular inflammation causing eventual axonal loss
risk factors of MS
female sex
latitude (⬆️ from equator)
Vitamin D deficiency
smoking
types of MS
relapsing-remitting (80%)
primary progressive
clinical features of MS
sensory disease (patchy paraesthesia)
optic neuritis
subacute cerebellar syndrome
weakness
investigations of MS
LP
MRI
bloods (FBC, LFTs, TFTs, Vitamin B12 and CRP/ESR)
common findings of investigations in MS
raised protein, immunoglobulins and presence of oligoclonal bands on LP
demyelinating lesions on MRI
management of acute MS episode
IV methylprednisolone
if unresponsive to glucocorticoids: plasma exchange
chronic management of MS
β-interferon or glatiramer
physiotherapy
symptomatic therapy
role of baclofen in MS management
anti-spastic medication
role of modafinil in MS
fatigue but can also use exercise therapy
role of clonazepam in MS
given to patients with tremors
role of gabapentin in MS
for patients in pain
role of anticholinergics and antidepressants in MS
to minimise urinary incontinence and manage low mood
