Peripheral neuropathy Flashcards

1
Q

Causes of peripheral neuropathy

A

Metabolic and endocrine- hyothyroidism, liver failure, renal failure, Posinfective po

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2
Q

Mechanism of peripheral nerve degeneration

A

Infarction – DM
Infiltration- leprosy and granulomas
Demyelination- Guillain-Barre Syndromes
Axonal degeneration- toxic neuropathies
Wallerian degemration
Compression- Carpal tunnel syndrome

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3
Q

Clinical fetures

A

Sensory : Paresthesia, burning pain, tingling sensation, numbness, loss proprioception, allodynia, loss of pain and temperature sensation

Motor: Wasting, hypotonia, hyporeflexia, fasciculation, deformity.

Autonomic: Postural hypotension, urinary retention, erectile dysfunction, diarrhea/constipation, diminished sweating, cardiac arrhythmias, gustatory sweating.

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4
Q

Diabetic neuropathy
Peripheral damage:

A
  1. Occlusion of th vasa nervorum
  2. Sorbitol and fructose accumulation in Schwann cells du
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5
Q

Common presentaios of diabetic neuropathy

A
  1. DIstal symmetrical polyneuropathy (stockings and gloves pattern)
  2. Acute painful neuropathyy
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6
Q

10 gram monofilament

A

for diabetic patiency

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7
Q

Carpal nerve
Median nerve entrapment

Clinical presentation:

A
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8
Q

Guillain-Barre syndrome

A

AIDP
Triggered by infections.

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9
Q

Investigation of peripheral neuropathy:

A

Urinalyis- glucose, protein
Haemotology- FBC, ESR, vitamin B12, folate
Biochemistry- HBA1c, fastingglucose, E/U/ Cr, LFT, TSH
CSF- protein high normal cell count. in GBS.
Nerve conduction studies
Electromyography (EMG)
Nerve biopsy: e.g. vasculities, sarcordoisis, CIDP, Leprosy,

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10
Q

Treatment

A

TREATMENT OF THE UNDERLYING CAUSE.

Treatment of neuropathic pain.

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11
Q

Nerve biopsy is useful in (5)

A

: most useful in inflammatory disorders such as vasculitis, sarcoidosis, CIDP, infectious diseases such as leprosy, or infiltrative disorders such as amyloidosis or tumour

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12
Q

Treatment of neuropathic pain

A
  1. Anticonvulsants- Gabapentin, pregabalin, sodium valproate
  2. Antidepressants- Amitriptyline, duloxetine, venlafaxine
  3. Opioids- tramadol, morphine, tapentadol
  4. Capsaicin cream
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13
Q

Anticonvulsants indicated for neuropathic pain.

A

Gabapentin, pregabalin, sodium valproate

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