peripheral neuropathy

Question 1

Distal sensory loss, tingling + absent ankle jerks/extensor plantars + gait abnormalities/Romberg’s positive →

Answer 1

subacute combined degeneration of the spinal cord

Question 2

post bariatric surgery impaired absorption of nutrients what condtion can arise causing PN

Answer 2

subacute combined degeneration of the spinal cord

Question 3

gradual onset and often involves pain, particularly in a ‘glove and stocking’ distribution

Answer 3

Diabetic neuropathy

Question 4

rapidly ascending weakness, areflexia( hypoflexia - muscles dont respond) , and sensory disturbances, often following an infection.

Answer 4

GBS

profound motor weakness and possibly autonomic dysfunction,

Question 5

Subacute combined degeneration of the spinal cord is due to vitamin B12 deficiency resulting in impairment of what tracts

Answer 5

dorsal columns, lateral corticospinal tracts and spinocerebellar tracts..

Recreational nitrous oxide inhalation

Question 6

features of subacute degen by cord

Answer 6

dorsal column involvement
distal tingling/burning/sensory loss is symmetrical and tends to affect the legs more than the arms
impaired proprioception and vibration sense

lateral corticospinal tract involvement
muscle weakness, hyperreflexia, and spasticity
upper motor neuron signs typically develop in the legs first
brisk knee reflexes
absent ankle jerks
extensor plantars

spinocerebellar tract involvement
sensory ataxia → gait abnormalities
positive Romberg’s sign

Question 7

Since GBS causes demyelination, NCS can reveal decreased motor nerve conduction velocity, prolonged distal motor latency, and increased F wave latency. would findings be in both limbs

Answer 7

yes symmetrical

Question 8

first sx in GBS

Answer 8

back pain

Question 9

what autonomic involvement is seen in later staged GBS

Answer 9

urinary retention
diarrhoea

Question 10

LB in GBS would show

Answer 10

rise in protein with a normal white blood cell count (albuminocytologic dissociation) - found in 66%

Question 12

Mononeuritis multiplex is what

Answer 12

simultaneous or sequential involvement of individual non-contiguous nerve trunks. It typically presents with acute or subacute loss of sensory and motor function of individual nerves. The pattern of involvement is asymmetric, however, as the disease progresses, deficit(s) becomes more confluent and symmetrical, making it difficult to differentiate from polyneuropathy.