Peripheral Nerve Lesions Flashcards

1
Q

What happens in terms of motor function in nerves affected by peripheral neuropathy?

A

Reduced power, tone or reflexes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two main causes of peripheral nerve lesions?

A

Axonal loss or peripheral demyelination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What symptoms can arise as a result of an autonomic neuropathy?

A

Dizziness (postural hypotension), nausea and vomiting, impotence, problems with bladder and bowel control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What do small fibre neuropathies cause?

A

Pain and dyesthesia, reduced pinprick and temperature sensation (no motor features)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is an example of a small fibre neuropathy? How does the damage causing these come about?

A

Congenital insensitivity to pain syndrome / axonal loss only (can’t be demyelination since they are not myelinated)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe what happens in mononeuritis multiplex?

A

Multiple single nerves are affected one by one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is likely to be the cause of mononeuritis multiplex?

A

Usually the result of a systemic condition e.g. vasculitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is Charcot-Marie-Tooth disease?

A

A clinically and genetically distinct cause of inherited neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does Charcot-Marie-Tooth disease present?

A

Symmetrical distal wasting and weakness, as well as foot deformities e.g. pes cavus, hammer toes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the onset of Charcot-Marie-Tooth disease?

A

A more chronic presentation which comes on over months-years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the most common inflammatory, immune mediated polyneuropathy?

A

Guillain Barre syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the onset of Guillain Barre syndrome?

A

Must develop within 6 weeks, usually reaching a peak at 2 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a condition similar to Guillain Barre syndrome but is less severe and relapsing?

A

Chronic inflammatory demyelinating polyneuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How does Guillain Barre syndrome usually present?

A

Sensory symptoms which progress to motor, with flaccid weakness starting in the legs and progressing to the arms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What often precedes Guillain Barre syndrome?

A

A respiratory or GI infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Aside from motor features of the extremities, what are some other features which can be seen in Guillain Barre syndrome?

A

Bulbar weakness, often causing dysphagia and dysarthria and can also get cranial nerve involvement. Respiratory muscle involvement can also occur.

17
Q

What happens to reflexes in Guillain Barre syndrome?

A

Can be normal at the beginning but will eventually be lost

18
Q

Is Guillain Barre syndrome painful?

A

Yes, back pain from nerve root inflammation is common

19
Q

What is a condition which can cause mixed UMN and LMN signs? Explain this.

A

B12 deficiency - causes degeneration of spinal cord tracts and peripheral nerves

20
Q

10% of people with Guillain Barre syndrome die from what?

A

Autonomic involvement causing arrhythmias

21
Q

How should Guillain Barre syndrome be treated?

A

IV immunoglobulin infusion, potentially plasma exchange

22
Q

How long does it take to recover from Guillain Barre syndrome?

A

Months-years

23
Q

What will a CSF sample of inflammatory peripheral neuropathy show?

A

Mildly raised WCC, high protein

24
Q

What is the main investigation used to help decipher between different types of neuropathy?

A

Nerve conduction studies

25
Q

What is a plexopathy? What can they cause?

A

Damage affecting a nerve plexus - extreme pain, muscle weakness and sensory problems

26
Q

What are some drugs which can cause peripheral neuropathy?

A

Alcohol, amiodarone, phenytoin, vincristine, cisplatin

27
Q

What is a condition which can present similarly to GBS? Who should be checked for this?

A

Porphyrias / any young person presenting with fitting features

28
Q

What are some chronic causes of autonomic neuropathy? What are some acute causes?

A

Diabetes, amyloidosis, hereditary conditions / GBS, porophyrias

29
Q

How should neuropathies due to axonal damage be treated?

A

Treat the underlying cause, supportive treatment

30
Q

How should neuropathy due to vasculitis be treated?

A

IV methylprednisolone and cyclophosphamide