Peripheral Neuropathies:Guillan Barre Syndrome

Question 1

Peripheral neuropathy involves?

Answer 1

mononeuropathy, mononeuropathy multiplex and polyneuropathy

Question 2

Peripheral neuropathies can be subdivided according?

Answer 2

-acute ve chronic
-axonal or demyelinating

Question 3

Diabetic neuropathy is a _____________________ type of peripheral neuropathy?

Answer 3

polyneuropathy

Question 4

What are the EARLY clinical features of diabetic neuropathy?

Answer 4

progressive loss of sensation in the distal extremeties (stocking-glove)

Question 5

What are the LATE clinical features of diabetic neuropathy?

Answer 5

-pain during rest and at night
-decreased pain perception
-motor weakness
-areflexia(loss of muscle response to stimuli)

Question 6

What are the different patterns of diabetic neuropathy?

Answer 6

-small-fibre predominant neuropathy (stocking-glove)
-autonomic neuropathy(damage to nerve that control autonomic functions)
-mononeuropathy (damage to a single nerve)
-radiculopathy(injury or damage to a nerve root)(pinched nerve)

Question 7

Guillain Barre Syndrome

Answer 7

immune-mediated disorders targetting the peripheral nerves

Question 8

What is an acute immune-mediated polyneuropathies?

Answer 8

Guillain Barre syndrome

Question 9

What are the major forms of Guillain Barre syndromes(acute immune-mediated polyneuropathies)?

Answer 9

1. Acute inflammatory demylinating polyradiculoneuropathy(AIDP)
   2.Miller Fisher syndrome(MFS)
2. Acute motor axonal neuropathy (AMAN)
3. Acute sensorimotor axonal neuropathy (ASMAN)

Question 10

What is the form of Guillian Barre syndrome that has ONLY motor symptoms?

Answer 10

acute motor-axonal neuropathy (AMAN)

Question 11

What is the form of Guillian Barre syndrome that has motor/sensory symptoms?

Answer 11

Acute sensorymotor axonal neuropathy (ASMAN)

Question 12

Where does the inflammatory demyelination start at the nerve roots?

Answer 12

Nodes of Ranvier

Question 13

Where is the inflammation of the demyelination more intense?

Answer 13

dorsal and ventral roots

Question 14

Axon degeneration extent is related to…?

Answer 14

intensity of the inflammatory response

Question 15

What are the earliest abnormalities seen on EMG in patients with AIDP?

Answer 15

prolonged or absent F waves and absent H reflexes

Question 16

What does the prolonged or absent F waves and absent H reflexes found in a EMG of AIDP patients mean?

Answer 16

reflects demyelination at the level of the nerve root

Question 17

What are the proven effective treatments for non ambulatory patients with Guillian Barre syndrome?

Answer 17

-IVIG (intra venous immunoglubulin)
-plasma exchange

Question 18

What happens if patient presents with bladder dysfunction and spinal nerve sensory loss?

Answer 18

NOT Guillian Barre Syndrome