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Clin Med III Disease Key Notes > Peripheral Neuropathies & ALS (Exam #4) > Flashcards

Peripheral Neuropathies & ALS (Exam #4) Flashcards

1
Q

How can you differentiate Radiculopathy from Peripheral Neuropathy?

A

Radiculopathy = nerve root lesion/compression NOT peripheral (involve segmental pattern/dermatomes)

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2
Q

How can you differentiate Myopathy from Peripheral Neuropathy?

A

Myopathy = proximal motor weakness with NO sensory

- Peripheral Neuropathy = distal motor weakness; ANY sensory

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3
Q

What is the most common nerve affected with Mononeuropathy Peripheral Neuropathy, and what condition does this result in?

A

Median n.

- Carpal Tunnel Syndrome (CTS)

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4
Q

What population is most affected by Polyneuropathy Peripheral Neuropathy?

A

DM patients

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5
Q

What are the five pathologies of Peripheral Neuropathy?

A
  • Mechanical
  • Vascular
  • Axonal
  • Neuronal
  • Demyelinating
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6
Q

What two causes can lead to Mechanical pathology of Peripheral Neuropathy?

A
  • Compression

- Entrapment

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7
Q

What two causes can lead to Vascular pathology of Peripheral Neuropathy?

A
  • Venous disease

- Arterial occlusion

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8
Q

How can you differentiate Vascular Peripheral Neuropathy from conditions like Polyarteritis Nodosa or RA?

A
  • Polyarteritis Nodosa or RA = widespread (MULTIPLE nerve distributions)
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9
Q

What does Axonal pathology of Peripheral Neuropathy likely indicate?

A

DM problems

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10
Q

What pathology of Peripheral Neuropathy involves symmetric with sensory loss in feet? Which two types of sensory are lost first?

A

Axonal = DM problems

- Thermal and vibratory lost first

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11
Q

Which pathology of Peripheral Neuropathy has SENSORY deficits dominating? Which has MOTOR deficits dominating?

A
  • Axonal = SENSORY

- Neuronal = MOTOR

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12
Q

What condition is the most common Neuronal Peripheral Neuropathy?

A

ALS

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13
Q

Which pathology of Peripheral Neuropathy involves involvement of distal AND proximal muscles + fasciculations?

A

Neuronal

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14
Q

Which pathology of Peripheral Neuropathy is immune-mediated?

A

Demyelinating

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15
Q

What is seen in CSF of ALL Demyelinating Polyneuropathies?

A

Elevated proteins in CSF

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16
Q

What two conditions are associated with Demyelinating Peripheral Neuropathy? What is the course of each?

A
  • Guillain-Barre = ACUTE

- Charcot-Marie-Tooth = CHRONIC

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17
Q

What pathology of Peripheral Neuropathy is Guillain-Barre associated with?

A

Demyelinating

18
Q

What condition involves pins and needles in feet that progresses to weakness in legs moving proximally?

A

Guillain-Barre

- Acute Demyelinating Peripheral Neuropathy

19
Q

What condition involves slowly evolving foot drop, distal wasting of intrinsic feet muscles?

A

Charcot-Marie-Tooth

- Chronic Demyelinating Peripheral Neuropathy

20
Q

What pathology of Peripheral Neuropathy is Charcot-Marie-Tooth associated with?

A

Demyelinating

21
Q

How does Polyneuropathy Peripheral Neuropathy sensory loss often present?

A

Distally as a “stocking glove” distribution

22
Q

What condition involves symmetric/generalized distal sensory and proximal motor sxs?

A

B-12 Deficiency

23
Q

What is the dx test of choice for Peripheral Neuropathies?

A

EMG/NCS

24
Q

Which pathology of Peripheral Neuropathy presents with denervation changes on EMG?

A

Axonal

25
Q

Which pathology of Peripheral Neuropathy presents with slowing on NCS?

A

Demyelinating

26
Q

What is seen on NCS with Mononeuropathy Peripheral Neuropathies?

A

Slowing in ONE nerve

27
Q

What is seen on NCS with Polyneuropathy Peripheral Neuropathies?

A

Slowing in MULTIPLE nerves

28
Q

What two meds/class of meds are considered for tx of Peripheral Neuropathies?

A
  • NSAIDs

- Gabapentin/Pregabalin

29
Q

What class of meds may be considered for tx of Peripheral Neuropathies if DM too?

A

TCAs (Amitriptyline)

30
Q

What is the recommended tx for Guillain-Barre? What meds do NOT help?

A

Supportive care

- Steroids do NOT help)

31
Q

What condition involves both upper AND lower motor neurons with NO sensory sxs?

A

Amyotrophic Lateral Sclerosis (ALS)

32
Q

What condition involves weakness in hands/arms moving distally?

A

Amyotrophic Lateral Sclerosis (ALS)

33
Q

How can you differentiate Amyotrophic Lateral Sclerosis (ALS) from Guillain-Barre?

A
  • ALS = weakness moves DISTALLY

- Guillain-Barre = weakness moves PROXIMALLY

34
Q

What condition involves both upper AND motor neuron signs in SAME limb?

A

Amyotrophic Lateral Sclerosis (ALS)

35
Q

What is the hallmark sign of Amyotrophic Lateral Sclerosis (ALS)?

A

Both upper AND lower motor neuron signs in SAME limb

36
Q

Fasciculations in what body part are often associated with Amyotrophic Lateral Sclerosis (ALS)?

A

TONGUE

that is a tongue → ‘U’

37
Q

What are three examples of UMN signs?

A
  • Increased tone
  • Hyperreflexia
  • Spastic
38
Q

What are three examples of LMN signs?

A
  • Wasting/atrophy
  • Hyporeflexia
  • Fasciculations
39
Q

What is the dx of Amyotrophic Lateral Sclerosis (ALS)?

A

Clinical

40
Q

What class of meds may be considered for tx of Amyotrophic Lateral Sclerosis (ALS), and what sxs do they specifically treat?

A

Anticonvulsants

- Tx fasciculations

Clin Med III Disease Key Notes (18 decks)

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