Peripheral Neuropathies

Question 1

Carpal Tunnel
- ET
- Pharm Tx

Answer 1

• ET = F>M, Preg
• Pharm Tx = Glucocorticoids

Question 2

Carpal tunnel tingling is resolved when _____

Answer 2

shaking your hands

Question 3

Femotal Neuropathy SS
- ____ Muscle weakness
- _____ sensory loss
- decr/Absent _____ DTRs

Answer 3

• Quadriceps muscle weakness (Adduction is spared bc obturator n.)
• Anterior/medial thigh sensory loss
• Patellar DTRs (decr/absent)

Question 4

Sciatica results in a decr ____ reflex

Answer 4

Calcaneal (achilles)

Question 5

Sciatics Tx

Answer 5

straight leg raise

Question 6

Diabetic neuropathy SS
- Bil or Unil?
- Pattern?

Answer 6

• MC = SYMMETRICAL
• Stocking-Glove pattern (further away is worse)

Question 7

Diabetics Neuropathy: Which sensation do you lose 1st?

Pain? Temp? Vibration?

Answer 7

Vibration -> Pain -> Temp

Question 8

Diabetic Neuropathy Tx for light tough hypersensitivity and burning pain

Answer 8

• SSRIs -> Duloxetine (Cymbalta)
• TCA -> Notriptyline (Pamelor), Desipramine (Norpramin)
• GABA

Question 9

Foot drop is d/t compression of the _____ n.

Answer 9

peroneal

Question 10

Foot drop produces a (+) ______ sign over the peroneal n. at level of the fibular head

Answer 10

Tinel’s Sign

Question 11

If pt has Foot Drop d/t Trauma, a Sx Nerve Resection should be done within ____ Hr

Answer 11

72

Question 12

Complex Regional Pain Syndrome
- ET
- WU
- Tx

Answer 12

• 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

Question 13

Guillain-Barrre Syndrome
- #1 ET
- Gender? Age?

Answer 13

• Campylobacter jejuni
• Males, ALL ages

Question 14

Guillain-Barrre Syndrome SS

Answer 14

• Progressive weakness of 2+ limbs, Bil SYMMETRIC Weakness usu begins in distal legs
• Sensory loss
• Poor reflexes
• Fever, Cough, ST, Rhinorrhea, Diarrhea

Question 15

Guillain-Barrre Syndrome CSF results

Answer 15

CSF = HIGH protein & Norm WBC

Question 16

Guillain-Barrre Syndrome Tx

Answer 16

• +/- Intubation
• DVT Prophylaxis (LWMH + Compression devices)
• GABA for pain
• IVIG, PLEX (plasma exchange)

Question 17

MC type of Charcot-Marie-Tooth Dz

Answer 17

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

Question 18

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

Answer 18

DOMINANT

Question 19

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

Answer 19

Hereditary Neuralgic Amyotrophy