peripheral neuropathy Flashcards
wallerian degeneration
from a discrete event
primary neuronal degredation
underlying abnormality of cell body or ganglion
Dying back neuropathy
distal degeneration of axons
Segmental vs uniform demyelination
segmental is from acquired disorders, uniform is hereditary disorder
how long does remyelination take? collateral sprouting? axonal regeneration?
6-8 wks. 2-6 months. 2mm/day, schwann cell lamina tube viable for 18-24 months
Length dependent patterns are usually ____ in origin. Generalized patterns? Named nerve? dermatomal?
axonal; demyelinating; axonal; axonal
Characteristics of axonal polyneuropathies
symmetrical. Length-dependent. Loss of reflexes.
Most common diabetic neuropathy: axonal or demyelinating? symmetric or unilateral? Autonomic involvement? Other contributing factors
axonal, symmetric, autonomic involvement, Treatment-induced (rapid control of BS leads to severe pain and autonomic dysfxn)
Vit B12: what else do you test for? where are abnormalities
methylmalonic acid and homocysteine. CNS and PNS
Uremic neuropathy: what GFR? Pattern?
<12 mL/min. Length dependent sensory and motor
Most toxic neuropathies are axonal or demyleinating?
axonal
Mononeuropathy multiplex: definition?
damage to multiple named nerves. Painful symptoms
AIDP: acronym? subtype of___? What size fiber affected? Symptoms? Complications? Axonal or demyelinating? Diagnosis? Risk factors? Tx
Acute inflammatory Demyelinating Polyneuropathy. Large fibers. Numbness progressing to generalized weakness. Respiratory failure. Demyelinating. Elevated CSF protein w/o WBC. previous infection. Plasma xchange and IVIg. NO steroids in GBS
When is CSF useful?
demyelinating neuropathies, infiltration (infection, malignancy).
CIDP: acronym? characteristics? tx?
chronic IDP. Slowly progressive, symmetrical, generalized weakness and numbness. Similar to AIDP except time course is longer. Treat with steroids (this isnt GBS), IVIg
