PERIPHERAL Neuropathies Flashcards
How different are the large nerve fibres from the small ones?
- Large fibres - more well myelinated
whereas the small nerve fibres are either THINLY myelinated or unmyelinated
What occurs with damage to the small sensory fibres?
- PAIN
- dysesthesia (UNPLEASANT sensation when touched)
- reduced pin prick and temperature sensation
Name the small sensory fibres.
- Adelta: thinly myelinated
- C: unmyelinated
What occurs with damage to the autonomic fibres?
- dizziness (d.t POSTURAL hypotension)
- impotence (ED)
- Nausea and vomiting (GASTROPARESIS)
- constipation/diarrhoea (esp. at night)
- bloating and belching
- tachycardia
- excessive sweating
- can’t empty bladder/ loss of bowel control
What are the symptoms of large sensory fibre damage?
- PARAESTHESIA
- unsteadiness
- numbness
- diminished vibration and JPS
- Reflexes may be lost
What occurs with large fibre motor damage?
PC:
- weakness/ unsteadiness/ wasting
SIGNS:
- REDUCED power
- absent reflexes
Name patterns of peripheral loss.
- glove and stocking
- mild/moderate/severe
- mononeuritis/ mononeuropathy
- radiculopathy
How may plexopathy occur?
- by traction of the nerve plexus
How are nerve damaged?
- axonal loss
- Peripheral nerve demyelination
Name an ACUTE demyelinating neuropathy.
- GBS (Guillaine Barre Syndrome)
- occurs within DAYS-wks
Name a chronic, progressive demyelinating neuropathy.
- CIDP (chronic inflammatory demyelinating polyradiculopathy)
- Hereditary sensory motor neuropathy (Charcot-Marie Tooth $)
How common is GBS?
1-2/ 100,000 per year
How does GBS present as?
- progressive paraplegia over days-4 weeks
- sensory symptoms precede weakness
- PAIN
- peak symptoms 10-14 days INTO onset of illness
When causes GBS?
- post-infectious CAMPYLOBACTER association
- campylobacter jejuni
WHat complications may arise from GBS?
- 25% require MECHANICAL ventilation
- 10% DIE mainly from autonomic failure (CARDIAC arrhythmia)
How is GBS treated?
- immunoglobulin infusion
AND/OR - PLASMA exchange
