Peripheral neuropathy

Question 1

What is the Peripheral nervous system (PNS)?

Answer 1

CRANIAL NERVES
SPINAL NERVES WITH THEIR ROOTS AND RAMI
PERIPHERAL NERVES
AUTONMIC NERVOUS SYSYTEM OUTSIDE CNS

Question 2

How neuropathies classified?

Answer 2

MOTOR
SENSORY
AUTONOMIC
AND BY DISTRIBUTION:
          MULTIFOCAL OR DIFFUSE

Question 3

What are symptoms of neuropathic injury?

Answer 3

WEAKNESS---DISTAL > PROXIMAL
PROMINENT ATROPHY
CRAMPING WITH FATIGUE IS COMMON
REFLEXES DECREASED OR ABSENT
DIMINISHED OR LOSS OF FEELING
PINS & NEEDLES SENSATION-PARESTHESIAS
UNPLEASANT SENSATIONS—DYSESTHESIAS

Question 4

Where is the neuropathy there is a decrease in vibration and position?

Answer 4

DYSFUNCTION IN LARGER FIBERS

Question 5

Where is the neuropathy there is a decrease in Pin(pain) or temperature?

Answer 5

ABNORMALITIES IN SMALLER FIBERS

Question 6

What does the pathology of Peripheral neuropathy involve?

Answer 6

MYELIN
AXON
BOTH

Question 7

What are causes of Peripheral neuropathy talked about in this lecture?

Answer 7

ACUTE INFLAMMATORY POLYRADICULONEUROPATHY (Guillain barre syndrome)

Diabetic neuropathy

Entrapment neuropathy

HEREDITARY MOTOR SENSORY NEUROPATHY

Question 8

What are symptoms of GBS?

Answer 8

ASCENDING PROGRESSIVE WEAKNESS, AREFLEXIA, HI CSF PROTEIN, MAY INVOLVE CN’S AND RESPIRATION
SENSORY LOSS MINIMAL-MILD
AXONAL LOSS CAN OCCUR LEADING TO LESS COMPLETE OR SLOWER RECOVERY
AUTONOMIC INSTABILITY MAY BE PROMINENT

Many develop in hours to days

Question 9

How is GBS caused?

Answer 9

ANTIGANGLIOSIDE ANTIBOIES( GM1, GD1A)
OFTEN PRECEDED BY INFECTION
Most usually recover

Question 10

How do you treat GBS?

Answer 10

INTRAVENOUS IMMUNOGLOBULIN( IVIG)
PLASMAPHERESIS

Question 11

What is the most common cause of Neuropathy?

Answer 11

DIABETIC NEUROPATHY 50-60% OF DIABETICS
PREVALENCE INCREASES WITH DURATION OF DISEASE
MAY BE INITIAL SYMPTOM OF DIABETES
PROBABLY MOST COMMON CAUSE OF NEUROPATHY

Question 12

What are the types of entrapment neuropathy?

Answer 12

CARPAL TUNNEL SYNDROME
ULNAR NEUROPATHY
RADIAL NERVE PALSY ( SATURDAY NIGHT PALSY)
PERONEAL NEUROPATHY
LATERAL FEMORAL CUTANEOUS NERVE SYNDROME ( MERALGIA PARESTHETICA)
TARSAL TUNNEL SYNDROME

Question 13

What are the types of hereditary motor sensory neuropathy?

Answer 13

CHARCOT-MARIE-TOOTH ( CMT ) TYPE1/HMSN 1

It is autosomal dominate

Question 14

What is CHARCOT-MARIE-TOOTH ( CMT ) TYPE1/HMSN 1?

Answer 14

GRADUAL PROGRESSIVE DISTAL WEAKNESS, ATROPHY, AND SENSORY LOSS OVER YEARS

Question 15

What is common in CHARCOT-MARIE-TOOTH ( CMT ) TYPE1/HMSN 1?

Answer 15

FOOT DROP—COMMON
FREQUENT HAMMER TOE, PES CAVUS
AUTOSOMAL-DOMINANT
SX BEGIN IN EARLY ADULTHOOD

Question 16

What is found in CHARCOT-MARIE-TOOTH ( CMT ) TYPE1/HMSN 1?

Answer 16

ENLARGED PALPABLE PERIPHERAL NERVES PARTICULARLY AURICULAR NERVE

SEVERELY SLOWED NCS ON EMG