Peripheral Neuropathies Flashcards
What is the typical history associated with peripheral neuropathies?
Gradual onset of numbness, tingling, burning pain, or weakness in the extremities. History of diabetes, alcohol abuse, or chemotherapy. Symmetric or asymmetric distribution.
What are the key physical examination findings in peripheral neuropathies?
Reduced sensation to pinprick, vibration, and temperature. Muscle weakness and atrophy. Reduced or absent deep tendon reflexes. Possible foot ulcers in severe cases.
What investigations are necessary for diagnosing peripheral neuropathies?
Electromyography (EMG) and nerve conduction studies. Blood tests: glucose, vitamin B12, thyroid function. Nerve biopsy in uncertain cases.
What are the non-pharmacological management strategies for peripheral neuropathies?
Physical therapy to maintain mobility and strength. Occupational therapy for daily living activities. Patient education on foot care and injury prevention.
What are the pharmacological management options for peripheral neuropathies?
Pain management: gabapentin, pregabalin, duloxetine. Medications to address underlying cause: glycemic control in diabetes, vitamin B12 supplementation. Topical treatments for localized pain.
What are the red flags to look for in peripheral neuropathies patients?
Rapidly progressive weakness. Severe autonomic symptoms: orthostatic hypotension, bowel or bladder dysfunction. Significant functional impairment.
When should a patient with peripheral neuropathies be referred to a specialist?
Refractory symptoms not responding to initial treatment. Severe or progressive neuropathy. Need for advanced diagnostic testing. Complex or atypical cases.
What is one key piece of pathophysiology related to peripheral neuropathies?
Damage to peripheral nerves causing impaired signal transmission. Common causes include diabetes, alcoholism, infections, and toxins. Results in sensory and motor deficits.
