Peripheral Neuropathies Flashcards
Carpal Tunnel
- ET
- Pharm Tx
- ET = F>M, Preg
- Pharm Tx = Glucocorticoids
Carpal tunnel tingling is resolved when _____
shaking your hands
Femotal Neuropathy SS
- ____ Muscle weakness
- _____ sensory loss
- decr/Absent _____ DTRs
- Quadriceps muscle weakness (Adduction is spared bc obturator n.)
- Anterior/medial thigh sensory loss
- Patellar DTRs (decr/absent)
Sciatica results in a decr ____ reflex
Calcaneal (achilles)
Sciatics Tx
straight leg raise
Diabetic neuropathy SS
- Bil or Unil?
- Pattern?
- MC = SYMMETRICAL
- Stocking-Glove pattern (further away is worse)
Diabetics Neuropathy: Which sensation do you lose 1st?
Pain? Temp? Vibration?
Vibration -> Pain -> Temp
Diabetic Neuropathy Tx for light tough hypersensitivity and burning pain
- SSRIs -> Duloxetine (Cymbalta)
- TCA -> Notriptyline (Pamelor), Desipramine (Norpramin)
- GABA
Foot drop is d/t compression of the _____ n.
peroneal
Foot drop produces a (+) ______ sign over the peroneal n. at level of the fibular head
Tinel’s Sign
If pt has Foot Drop d/t Trauma, a Sx Nerve Resection should be done within ____ Hr
72
Complex Regional Pain Syndrome
- ET
- WU
- Tx
- ET = F>M, Crush injury, Sx, Idiopathic
- WU = XR -> Bone Scan
- Tx = NSAIDs, GABA, Topical Lidocaine cream
NO OPIODS BC IT WILL HURT MORE IN THE FUTURE
Guillain-Barrre Syndrome
- #1 ET
- Gender? Age?
- Campylobacter jejuni
- Males, ALL ages
Guillain-Barrre Syndrome SS
- Progressive weakness of 2+ limbs, Bil SYMMETRIC Weakness usu begins in distal legs
- Sensory loss
- Poor reflexes
- Fever, Cough, ST, Rhinorrhea, Diarrhea
Guillain-Barrre Syndrome CSF results
CSF = HIGH protein & Norm WBC
Guillain-Barrre Syndrome Tx
- +/- Intubation
- DVT Prophylaxis (LWMH + Compression devices)
- GABA for pain
- IVIG, PLEX (plasma exchange)
MC type of Charcot-Marie-Tooth Dz
CMT1 (Demylinating Form)
- AUTOSOMAL DOMINANT
- Pes Cavus
- Areflexia
- “Stork-leg” distal calf muscle atrophy
- freq ankle sprains
- SLOW EMG
- Nerve Bx -> “ONION BULBS”
CMT2 (Axonal form) is less common
The following hereditary peripheral neuopathies are ALL Autosomal ________
- Charcot-Marie-Tooth Dz
- Hereditary Neuropathy + Liability to Pressure Palsies
- Hereditary Neuralgic Amytrophy
- Hereditary Sensory & Autonomic Neuropahty
DOMINANT
Which hereditary peripheral neuropathy causes shoulder/arm pain/paresis, Short stature, small facies, and hyoptelorism (big space b/w eyes)?
- Charcot-Marie-Tooth Dz
- Hereditary Neuropathy + Liability to Pressure Palsies
- Hereditary Neuralgic Amytrophy
- Hereditary Sensory & Autonomic Neuropahty
Hereditary Neuralgic Amyotrophy
