Peripheral Neuropathies Flashcards
What is a Polyneuropathy
Diffuse damage to several peripheral nerves
- can be pure motor or pure sensory
- can be mixed (most common)
- can be autonomic
What is a Radiculopathy
Damage to a nerve root
What is a Plexopathy
Damage to a nerve plexus
- e.g. brachial or lumbosacral
Mononeuropathy
Damage isolated to a single nerve
What are (broadly) the causes of polyneuropathy
- Inherited
- Metabolic
- Drug-induced
- Inflammatory/autoimmune
What is an example of an inherited polyneuropathy
Charcot-Marie-Tooth
What are some metabolic causes of polyneuropathy
- Diabetes: predominantly sensory
- B12 deficiency: part of broader neuro syndrome
- Chronic Liver/Renal failure
- Hyperthryoidism (rare)
What are 2 autoimmune/inflammatory peripheral polyneuropathies
- Guilain-Barre syndrome
- Chronic idiopathic Demyelinating Polyneuropathy (CIDP)
What are they symptoms of a median nerve mononeuropathy
AKA carpal tunnel syndrome
- Pain + discomfort in hand radiating to forearm
- Commonly wakes from sleeping
- Relieved on shaking wrist
What do you look for in a median nerve examination
- Thenar eminance wasting
- Positive Tinnels + Phalens test
Median nerve neuropathy - Management
- Splint at night
- Steroid injections
- Surgical decompression
Where is the ulnar nerve most at risk of injruy
At the elbow (spiral groove)
Ulnar nerve neuropathy - Clinical Features
- Numbness in little + ring finger
- Numbness at ulnar border of hand
- Wasting of 1st dorsal interosseous
- Claw hand (4th + 5th fingers)
What is the ulnar paradox
Ulnar nerve neuropathy appears less deforming the more proximal the lesion
- as it also denervate the flexer muscles as well as extensor
What is the special test for the Ulnar nerve
Froment’s test
- have to use pincer grip to pick up paper
