Peripheral neuropathies Flashcards

1
Q

List four examples of peripheral neuropathies

A
Bell's palsy
GBS
Charcot marie tooth syndrome
Carpal tunnel syndrome
Ulnar nerve palsy
Peroneal nerve palsy
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2
Q

What are the symptoms of peroneal palsy?

A

foot drop- can’t walk on heels

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3
Q

Which spinal nerves form the common peroneal nerve?

A

L4-S1

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4
Q

What are the features of ulnar palsy?

A

ulnar claw/sign of benediction

parasthesia

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5
Q

Which tests are positive in carpal tunnel syndrome?

A

tinel’s and phalen’s

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6
Q

Which nerve is damaged in carpal tunnel syndrome?

A

median nerve

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7
Q

List two causes of sensory neuropathy

A

alcohol
B12
DM
Every vasculitis!!!

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8
Q

List two causes of motor neuropathy

A

GBS
lead poisoning
paraneoplastic

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9
Q

Two causes of autonomic neuropathy?

A

DM
HIV
SLE
GBS

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10
Q

List three features of autonomic neuropathy

A
  Postural hypotension 
  ED, ejaculatory failure 
  ↓ sweating 
  Constipation / Nocturnal diarrhoea 
  Urinary retention 
  Horner’s
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11
Q

List two classic motor signs in charcot marie tooth?

A

symmetrical muscle atrophy

  • champagne bottle- peronal muscles
  • hand and arm- claw hand
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12
Q

Which nerve is predominantly affected in charcot marie tooth?

A

peroneal nerve

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13
Q

What are the types of peripheral neuropathies?

A

motor, sensor, autonomic

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14
Q

What is the clinical presentation of large sensory nerve fibres?

A

sensory ataxia, loss of vibration sense, numbness tingling

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15
Q

Clinical presention for small sensory fibres?

A

impaired pin prick, temp, painful burning, numbness and tingling

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16
Q

What is the function of large myelinated fibres?

A

involved in proprioception, vibration and light touch

17
Q

What is the function of thinly myelinated and small nerve fibres?

A

light touch, pain, temp

18
Q

What is the most common of polyneuropathy?

A

length dependent axonal neuropathy

19
Q

What are the features of length dependent axonal neuropathy?

A

symmetrical, starts in toes, slowly progressive, mild weakness, diffuse

20
Q

What are the causes of length dependent axonal neuropathy?

A

diabetes, alcohol, nutritional, immune, renal failure, drugs, infections, inherited, myeloma, critical illness-bed bound

21
Q

What are examples of nutritional causes of length…neuropathy?

A

folate B12 thiamine B6

22
Q

Immune causes of length dependent axonal neuropathy?

A

RA, lupus, vasculitis

23
Q

Infections?

A

HIV, hep B and C

24
Q

What causes GBS to arise?

A

post infection e.g. campylobacter, EBV, CMV

25
Q

How are neuropathies diagnosed?

A

nerve conduction studies

26
Q

How can you distinguish between axonal or demyelinating causes of polyneuropathy?

A

in axonal degeneration- the amplitude of the response would be lessened but the time would be the same compared to normal, however the opposite is the case in demyelinating, where the amplitude remains the same but is slower to manifest= conduction delay

27
Q

Which 5 sites are most commonly affected in mononeuritis multiplex?

A

radial, common peroneal, axillary, median, sciatic

28
Q

If the common peroneal nerve is affected, what would be the clinical presentation?

A

weak ankle dorsiflexion, sensory disturbance of lateral aspect of calf and foot

29
Q

Axillary?

A

weakness of shoulder abduction, ‘badge’ of sensory disturbance inf deltoid region

30
Q

Femoral?

A

weak hip flexion and knee extension, sensory disturbance lat calf and dorsum of foot

31
Q

Median?

A

LOAF weakness, sensory disturbance

32
Q

Radial nerve?

A

wrist/finger drop, sensory disturbance of dorsum of hand

33
Q

Which cancer can result in mononeuropathy?

A

lymphoma

34
Q

What are causes of mononeuropathies?

A

diabetes, vasculitis, RA, lupus, sarcoidosis, lymphoma, infective