Peripheral Neuropathies- Terms first

Question 1

Myopathy

Answer 1

Symmetric bilateral proximal limb weakness that does not involve the face or orbits
Waddling gait, atrophy, hyporeflexia

Question 2

Neuromuscular junctionopathy

Answer 2

Diffuse dysfunction of neuromuscular junctions
Weakness of orbital muscles, larynx, pharynx, face, opthalmoparesis
Dysarthria, dysphagia, dysphonia

Question 3

Polyneuropathy

Answer 3

Diffuse dysfunction of peripheral nerves, abnormalities starting in feet and hands
Decreased muscle stretch reflexes, weakness of foot dorsiflexion– high stepping, slappping, ataxic gait

Question 4

Median neuropathy at carpal tunnel

Answer 4

Dysfunction of median nerve where it passes through the carpal tunnel
Involves skin of : entire anterior hand, distal posterior thumb, index finger, middle finger, lateral half of ring finger; palm is spared
LMN abnormalities in thenar muscles- weakness of opposition, abduction, flexion of thumb

Question 5

Ulnar neuropathy at the elbow

Answer 5

Lesion of ulnar nerve where it passes through structures around the medial elbow
Involves skin of: anterior and posterior parts of the medial hand including the little finger and medial half of the ring finger
LMN abnormalities: weakness in abduction and adduction of digits, little finger opposition, extension of ring and little finger. all muscles except thenar
Possible to see weakness of distal arm muscles, weakness of ring and little finger flexion or wrist flexion

Question 6

Radial neuropathy at spiral groove

Answer 6

Lesion of radial nerve where it passes around the posterior part of the humerus in the proximal arm
Involves skin of: lateral part of posterior hand including prosimal parts of the posterior thumb, index finger, middle finger, and lateral half of ring finger
LMN abnormalities in muscles of distal arm, wrist drop, weakness of thumb abduction, hand supination, elbow flexion, diminished brachioradialis reflex

Question 7

Lateral femoral cutaneous neuropathy

Answer 7

Lesion of lateral femoral cutaneous nerve at the inguinal ligament
Somatosensory abnormalities of lateral part of proximal leg

Question 8

Common peroneal neuropathy at the knee

Answer 8

Lesion of common peroneal nerve at the lateral knee
Involvement of skin of the lateral part of distal leg and superior and medial parts of foot
LMN abnormalities in muscles of foot dorsiflexion, foot eversion, toe extension

Question 9

5th lumbar radiculopathy

Answer 9

Lesion of L5 or its roots when passing out of the spine
Involvement of the skin of lateral parts of proximal and distal leg and superior and medial parts of foot
LMN: weakness of muscles of hip abduction, knee flexion, foot dorsiflexion, foot eversion, foot inversion, toe extension
(distinguish from common peroneal based on foot inversion)

Question 10

1st sacral radiculopathy

Answer 10

Lesion of S1 or its roots as it passes out of the spine
Involvement of skin of posterior parts of proximal and distal leg, inferior and lateral parts of foot
LMN: weakness of muscles of hip extension, knee flexion, foot plantarflexion, toe flexion. Achilles reflex may be diminished

Question 11

7th cervical radiculopathy

Answer 11

Lesion of C7 as or its roots as it passes out of the spine
Involvement of skin of posterior parts of proximal and distal arm, posterior hand, anterior and posterior middle finger
LMN: weakness in muscles of elbow extension, hand pronation, wrist flexion and extension, finger extension
Triceps reflex may be diminished

Question 12

6th cervical radiculopathy

Answer 12

Lesion of C6 or its roots as it passes out of the spine
Involvement of skin of lateral parts of proximal and distal arm, lateral hand, anterior and posterior thumb and index finger
LMN abnormalities in muscles of elbow flexion, hand supination, wrist extension
Biceps and brachioradialis reflexes may be diminished