PERIPHERAL NEUROPATHY

Question 1

symptoms of large fibre motor loss?

Answer 1

-weakness
-unsteadiness
-wasting

Question 2

symptoms of large fibre sensory damage?

Answer 2

-numbness
-paraesthesia
-unsteadiness

Question 3

symptoms of small fibre nerve damage

Answer 3

-pain
-dysthesia

Question 4

symptoms of autonomic nerve damage

Answer 4

-dizziness (postural hypotension)
-impotence
-nausea and vomiting (gastroperesis)
-absence of sinus arrythmia

Question 5

what is the power, sensation and reflexes like for large fibre motor nerve damage?

Answer 5

power- reduced
sensation- normal
reflexes- absent

Question 6

what is the power, sensation and reflexes like for large fibre sensory nerve damage?

Answer 6

power- normal
sensation- vibration and JPS reduced, pin prick and temperature reduced
reflexes- absent

Question 7

what is the power, sensation and reflexes like for small fibre nerve damage?

Answer 7

power- normal
sensation- pin prick and temperature reduced
reflexes- present

Question 8

what is the power, sensation and reflexes like for autonomic nerve damage?

Answer 8

power- normal
sensation-normal
reflexes- present

Question 9

what in the nerve must be damaged for plexopathy?

Answer 9

plexus of nerve

Question 10

what in the nerve must be damaged radiculopathy/ ganglionopathy?

Answer 10

ganglion?

Question 11

what nerve damage does this suggest

Answer 11

median nerve damage (carpal tunnel)

-wasting of thenar eminence

Question 12

damage to what nerves cause wrist drop and foot drop

Answer 12

wrist drop- radial
foot drop- common peroneal

Question 13

common causes of axonal neuropathies?

Answer 13

Question 14

common causes of peripheral demyelenation damage to nerves?

Answer 14

usually acute but can also be chronic

examples:
Guillain-Barre syndrome (acute)
CIDP (chronic inflammatory demyelinating polyradiculopathy)

Question 15

how to tell the difference between axonal and demyelenation damage to nerves?

Answer 15

Do electrical studies (sensory and motor)
-demyelenation will take longer to due damage to myelin sheath

Question 16

example of acute demyelinating neuropathy?

Answer 16

-Guillaine Barre syndrome
-AIDP

Question 17

example of chronic demyelinating neuropathy?

Answer 17

-CIPD (chronic inflammatory demyelinating polyradiculopathy)
-Hereditary sensory motor neuropathy (charcot marie tooth disease)

Question 18

treatment of axonal peripheral neuropathy?

Answer 18

-treat cause (ie clear hepatitis C)
-symptomatic relief (physio, orthotics, neuropathic pain relief)

Question 19

treatment of axonal (vasculitic) peripheral neuropathy?

Answer 19

Pulsed IV methylprednisolone + cyclophosphamide

Question 20

treatment of demyelinating (inflammatory neuropathy) peripheral neuropathy?

Answer 20

-IVIg (pooled immunoglobulin from donors)
-steroids
-azathioprine, mycophenalate, cyclophosphamide