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Neurology > Peripheral Neuropathies > Flashcards

Peripheral Neuropathies Flashcards

1
Q

What is peripheral neuropathy?

A

outside of the brain and spinal cord

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2
Q

Peripheral neuropathy - cx: US and WW?

A

US: diabetes
WW: leprosy

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3
Q

What is mononeuropathy?

A

affecting only one nerve

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4
Q

Mononeuropathy - cx?

A

compression

trauma

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5
Q

Mononeuropathy - ex?

A

carpal tunnel

winging of scapula

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6
Q

Multiple mononeuropathy?

A

more than one nerve- NOT symmetrical

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7
Q

Multiple mononeuropathy - ex?

A

wake up and hand falls asleep: ulnar and median n.

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8
Q

Polyneuropathy?

A

more than one nerve - SYMMETRICAL

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9
Q

Polyneuropathy - classic sx?

A

stocking-glove

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10
Q

Polyneuropathy - cx?

A

diabetes

SLE

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11
Q

Diabetic peripheral neuropathy- cx?

A

very common

microvascular prob: not enough blood to the nerves

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12
Q

Diabetic peripheral neuropathy categories?

A

Diabetic sensorimotor polyneuropathy

Asymmetric diabetic neuropathy

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13
Q

Diabetic sensorimotor polyneuropathy?

A

mixed neuropathy: sensory, motor, autonomic

axon

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14
Q

Diabetic sensorimotor polyneuropathy - sx?

A

stocking globe sx
symmetric
chronic
usually starts from the feet then makes its way up to the hands (length dependent neuropathy)

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15
Q

Diabetic sensorimotor polyneuropathy - PE?

A

decreased DTR

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16
Q

Asymmetric diabetic neuropathy - sx?

A

asymmetric
acute
6th CN - abducens (painless double vision-diplopia)

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17
Q

Asymmetric diabetic neuropathy -hx?

A

LONG STANDING DIABETES

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18
Q

Diabetic sensorimotor polyneuropathy and asymmetric diabetic neuropathy - tx?

A 
TCA
opioids - avoid
gabapentin 
SNRI
pregabalin
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19
Q

Chronic renal failure associated neuropathies - uremic neuropathy-sx?

A

polyneuropathy
stocking glove
demylination

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20
Q

Uremic neuropathy - tx?

A

dialysis - stabilize neuropathy

renal transplant - resolves neuropathy

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21
Q

Metabolic neuropathy?

A

diabetic peripheral neuropathy

uremic neuropathy

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22
Q

Axonal vs demyelination?

A

axonal-not treatable (permanent damage); length dependent

demyelination - treatable; myelin sheath (axon is spared)

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23
Q

Infection related neuropathies?

A

Bell’s palsy
Lyme dz
Herpes Zoster
Cytomegalic Virus (HIV/AIDs)

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24
Q

Bell’s palsy?

A

paresis of CN VII (facial n)
acute
mononeuropathy

25
Q

Bell’s palsy -sx?

A 
drooping of one side of face
diff from stroke: able to frow brow 
unilateral loss of taste
ear pain 
hyperacusis (hearing sensitivity)
26
Q

Bell’s palsy - cx?

A

HSV

27
Q

Bell’s palsy - PE?

A

sensory is intact

motor prob

28
Q

Bell’s palsy- tx?

A

acyclovir

self-limiting

29
Q

Ramsay Hunt syndrome?

A

reactivation of herpes zoster

DO NOT MISS -NERVE IS DYING!!

30
Q

Ramsay Hunt syndrome - sx?

A

vesicular outbreak in auditory canal/pharynx

31
Q

Acoustic neuroma?

A

can have sx of Bell’s palsy but this is insidious, Bell’s palsy is acute

32
Q

Lyme dz?

A

borrelia burgdoferi infxn

33
Q

Lyme dz - tx?

A

marcolide

tetracycline

34
Q

Lyme dz - sx?

A

bullseye

35
Q

Postherpetic neuralgia -sx?

A

pain after shingles (NOT only CN VII- throughout body)

36
Q

Postherpetic neuralgia - tx?

A

gabapentin

37
Q

Toxic neuropathies?

A

chronic - d/t repeated exposure to toxic (ie. lead poisoning)
can be: motor (lead), sensory (ethambutol), autonomic (vincristine), or all
pts who are going undergoing chemo

38
Q

Toxic neuropathies - tx?

A

pyridoxine to prevent and treat isoniazid

39
Q

Nutritional neuropathies?

A

lack of thiamine B1, pyridoxine B6, vit B 12

40
Q

What can B12 deficiency cx?

A

pernicious anemia –> sensory neuropathy d/t lack of intrinsic factor from the gut

41
Q

Nutritional neuropathies - cx?

A 
poor nutrition (eating disorders)
malabsoprtion syndrome (celiac dz, no gut - trauma)
42
Q

Nutritional neuropathies -sx?

A

distal
symmetric
polyneuropathy

43
Q

Inherited neuropaties?

A

Charcot marie-tooth

44
Q

Charcot marie tooth?

A

most common inherited dz

45
Q

Charcot marie tooth - sx?

A 
chronic
distal
SENSORY AND MOTOR neuropathy 
gait diffculuties 
no until late years - physical deformities of foot start to show
46
Q

Charcot marie tooth - PE?

A

hammer toes
high arch
wasting of distal leg muscles - can lead to arm and hands

47
Q

Guillian - Barree syndrome?

A

autoimmune neuropathy

48
Q

Guillian baree syndrome?

A

autoimmune neuropathy

49
Q

Guillian baree sx - sx?

A 
acute
inflammatory demylineation 
polyneuropathy
motor paralysis
ascending paralysis over hours to days
rubbery legs
may have autonomic instability -> ventilator support
NO FEVER
50
Q

Guillian baree sx- PE?

A

dec DTR

51
Q

Guillian baree sx - labs?

A

LP

  • increase protein
  • norm glucose
  • norm cell ct
  • clear/turbid
52
Q

Guillian baree sx - cx?

A

1-3wks after infection - Campylobacter jejuni

53
Q

Guillian baree sx - prognosis?

A

good; all recover w/in months-yr

54
Q

Guillian baree sx- tx?

A

plasmapheresis
HD IV immune globulin
BEGIN EARLY

55
Q

Trigeminal Neuralgia?

A

tic couloureux

56
Q

Trigeminal neurlagia - sx?

A

shock like lasts 1-2 sec –> wincing

57
Q

Trigeminal neurlagia - PE?

A

able to find trigger zone

58
Q

Trigeminal neurlagia - tx?

A

Carbamazepine

+/-surgery

59
Q

Diabetic sensorimotor polyneuropathy - tx? first line fails?

A 
1) gabapentin
#1 fail? --> TCA

Neurology (13 decks)

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