Peripheral neuropathies, Charcot, Diabetic PN, Vitamin B12, Thiamine

Question 1

What is a Charcot Marie Tooth disease?

Answer 1

Loss of sensory and motor function to both the upper and lower extremities

Question 2

What are the early signs of Charcot Marie Tooth disease

Answer 2

Foot drop

Hammer toes

Stork leg

Question 3

How do patients with Diabetic neuropathy describe their symptoms

Answer 3

Stocking-glove

- May feel numbness, or deadness like when wearing a sock or glove

Question 4

What Negative are symptoms in Diabetic peripheral Neuropathy?

Answer 4

Numbness, tingling, deadness (like when wearing a sock or glove)

Question 5

Physical exam findings expected with Diabetic peripheral neuropathy

Answer 5

1. Decreased vibratory sense from a tuning fork
2. Decreased monofilament sense
3. Decreased Deep Tendon reflexes
4. Absent gag reflex
5. Decreased strength

Question 6

What are positive symptoms in Diabetic peripheral neuropathy

Answer 6

Burning, prickling, stinging

Question 7

Treatment for Diabetic peripheral neuropathy

Answer 7

1. Monitor glucose

2. Refer to podiatrist for foot education and to prevent ulcers

Question 8

What is the classic triad seen in Vitamin B12 deficiency

Answer 8

Weakness
Sore tongue
Paresthesia

Question 9

Labs ordered for a Vitamin B12 deficiency

Answer 9

1. B12 aka Cobalamin

2. Schillin test - detects if low levels of intrinsic factor are main cause of B12 deficiency

Question 10

Signs and Symptoms of a thiamine deficiency

Answer 10

1. Memory problems
2. Sleep disturbance
3. Irritability

Question 11

What diseases are thiamine deficiencies commonly linked to?

Answer 11

1. Wernicke’s encephalopathy

2. Korsacoff syndrome

Question 12

Which diagnostic study will confirm if a neuropathy is peripheral in origin

Answer 12

Nerve conduction velocity test and/or electromyogram – confirms peripheral nerve origin