peripheral neuropathies

Question 1

Bell’s Palsy
Unilateral or bilateral? facial muscles weakness without cause
Most commonly seen in patients who are ___ or have ___
** Affects Cranial nerve ___

Answer 1

Bell’s Palsy
Things you should know
Unilateral facial muscles weakness without cause/RIGHT SIDE 60%
Most commonly seen in patients who are pregnant or have diabetes
** Affects Cranial nerve VII

Question 2

bells palsy may be due to what virus

Answer 2

herpes

Question 3

bells palsy

• duration
• cannot do what actions
• pain location
• can affect what senses
• weakness peaks when

Answer 3

hrs to 2 days
pts not able to close eye, raise brow, or smile on affected side
pain ipsilateral ear precedes weakness
impairment of taste, lacrimation, hyperacusis(hearling)
weakness peaks 21 days and recovery is 6 monts

Question 4

other disorders that may produce facial paralysis

Answer 4

stroke, tumor, lyme disease, AIDS, sarcoidosis

Question 5

what % of cases of bells palsy resolve spontaneously

Answer 5

60%

Question 6

what 3 factors of bells palsy associated with a poorer prognosis

Answer 6

complete palsy, hyperacusis, old age

Question 7

what medication can increase pts to a complete recovery

Answer 7

course of oral prednisone

Question 8

Diabetic peripheral neuropathy:
Neuropathy is secondary to ___ insufficiency.
There is a direct relationship between degree of ___ and ___

Answer 8

Neuropathy is secondary to vascular insufficiency.

There is a direct relationship between degree of hyperglycemia and nerve damage

Question 9

Painful numbness and tingling in my feet
Loss of bowel or bladder function
Erectile dysfunction
Indigestion
I get light headed when I stand up 
I’m sweating a lot

Answer 9

Diabetic peripheral neuropathy:
Painful numbness and tingling in my feet
Loss of bowel or bladder function
Erectile dysfunction
Indigestion (slow gastric emptying)
I get light headed when I stand up (postural hypotension)
I’m sweating a lot (poor thermoregulation)

Question 10

uremia
alcohol abuse
nutritional deficiencies
connective tissue disease
vasculitis 
vit B12 def
hypothyroidism
amyloidosis

Answer 10

all cause polyneuropathy

Question 11

duloxetine (cymbalta)

Answer 11

serotonin and norepi reuptake inhibitory for painful diabetic neuropathy

Question 12

amitripyline, nortripyline, desipramine, gabapentin, pregablin

Answer 12

meds for controlling deep, constant, aching pain

Question 13

fludrocortisone or midodrine

Answer 13

for postural hypotension

Question 14

What is the best way to avoid diabetic neuropathy

Answer 14

Tight glycemic control

Question 15

A 52 year old overweight male presents complaining of erectile dysfunction. What metabolic disorders should you be thinking of?

Answer 15

DM

Atherosclerosis