Peripheral Neuropathies Flashcards

2
Q

What are peripheral neuropathies and what are they also known as?

A

Peripheral nerve damage causing motor, sensory and or autonomic dysfunction, also known as polyneuropathies

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3
Q

Name 3 inherited peripheral neuropathies

A
  1. MND
  2. Charcot-Marie Tooth
  3. SMA
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4
Q

Name 3 acquired peripheral neuropathies

A
  1. GBS
  2. Diabetic
  3. Associated with infection/disease
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5
Q

What is Guillain Barres Syndrome (GBS)?

A

Acute demyelination of peripheral nerves (autoimmune inflammatory condition)

Idiopathic

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6
Q

How can GBS result in paralysis?

A

Multiple adjacent nerve fibres become demyelinated (nerve block)

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7
Q

What are common symptoms of GBS?

A

Paralysis (rapid onset - hours)
Loss of strength
Altered sensation

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8
Q

What usually precedes onset of GBS?

A

Respiratory tract or GI infection

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9
Q

What is the prognosis for GBS?

A

Generally recoverable (80% of Pts have complete recovery in 12 months)

Some (5-15%) have relapses
- chronic inflammatory demyelinating polyneuropathy (CIPD)

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10
Q

Is there spasticity or dexterity loss in GBS?

A

No as it only affects lower motor neurons

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11
Q

What are the impairments of GBS? (Primary and secondary)

A

Primary Impairments:

  • Strength loss
  • Sensation loss
  • Autonomic dysfunction

Secondary Impairments:

  • Contracture
  • Loss of function
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12
Q

What are the main physiotherapy principles for treating GBS? (3)

A
  1. Restore motor function
  2. Maintain cardiorespiratory and neuromuscular system while waiting for remyelination to occur
  3. Use principles of specificity, repetition and feedback
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13
Q

What are treatment options for GBS? (Rx = 4 categories; 3 notes)

A

Strength/ROM

  • Positioning
  • Tilt table
  • Serial casting ? to prevent contracture due to extreme weakness

Respiratory physiotherapy
Sensory retraining
Task training

Note:

  • Don?t use ES (sensation loss)
  • Dexterity is not a problem so don’t do early modified task practice
  • Focus on strength
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14
Q

What does the research say about strength training in GBS?

A

Mild strengthening, stretching and aerobic exercise over 6 weeks
= significant strength and QoL increase

Overwork weakness doesn’t seem to be the case

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15
Q

Research about general exercise in GBS

A

12 week cycling, 30mins 3x/week

= less fatigue, mobility, perceived physical/mental function

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16
Q

What is Motor Neurone Disease? (MND)

A

Terminal progressive degenerative disease affecting:

  • Anterior horn cells
  • Corticospinal tract
  • Motor nuclei of brain stem
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17
Q

What are the results of MND?

A
Upper and lower motor lesions
Bulbar palsy (dysarthria and dysphasia)
18
Q

What is the difference between dysarthria and dysphasia?

A

Dysarthria - problems with articulation and pronunciation

Dysphasia = receptive or expressive

  • receptive: difficulty with comprehension
  • expressive: difficulty putting words together to make meaning
19
Q

What are the 3 main forms of MND?

A

Amyotrophic lateral sclerosis ? 65% (UMN, LMN and bulbar)

Progressive bulbar palsy - 25% (speech and swallowing)

Progressive muscular atrophy ? 10% (only LMN, slower progress, 5-10 years)

20
Q

Additional problems involved with MND (8)

A

Problems

  • Pain
  • SOB
  • Eye soreness
  • Insomnia
  • Fatigue
  • Pressure areas
  • Constipation
  • Urinary retention
21
Q

Physiotherapy role in MND (6)

A

Educate and reassure
Pain management

Maintain (strength, ROM)
Promote mobility and independence (aids and adaptive)
Fatigue management
Manage respiratory dysfunction

22
Q

Should people with MND exercise?

A

Yes (likely to help improve QoL)

  • safe, low intensity (minimise fatigue)
  • stretching, strengthening and aerobic
23
Q

What assistive devices are common with MND?

A

Devices

  • Seats (mm length, comfort, social interaction)
  • Orthoses
  • Neck collars (cervical weakness)
  • Mobile arm supports/splints
  • Communication systems