Peripheral Neuropathy

Question 1

are reflexes absent in large or small fibre neuropathies?

Answer 1

large

Question 2

damage to what nerve fibres will cause loss of power in PN

Answer 2

large motor fibres

Question 3

symptoms of large fibre motor PN

Answer 3

weakness
unsteadiness
muscle wasting

Question 4

what fibres tend to cause numbness and paraesthesia

Answer 4

large sensory fibres

Question 5

symptoms of large fibre sensory PN

Answer 5

numbness
paraesthesia
unsteadiness

Question 6

what sensations are reduced in large fibre sensory PN

Answer 6

vibration

proprioception

Question 7

what sensations are reduced in small fibre PM

Answer 7

pin prick

temperature

Question 8

symptoms of small fibre PN

Answer 8

pain

dyesthesia

Question 9

what is dyesthesia?

Answer 9

an abnormal unpleasant sensation felt when touched

Question 10

symptoms of autonomic PN

Answer 10

postural hypotension
impotence
N+V from gastroparesis

Question 11

power and sensation are normal in autonomic PN T or F

Answer 11

T

Question 12

define pseudoathetosis

Answer 12

abnormal writhing movements, usually of the fingers, caused by failed proprioception

Question 13

a radiculopathy relates to damage to a nerve where?

Answer 13

nerve root

Question 14

what pattern does PN tend to present in

Answer 14

stocking glove pattern

legs affected THEN finger tingling

Question 15

mononeuritis multiplex has what distribution?

Answer 15

right half of both palms

right half of RIGHT anterior leg

Question 16

what damage actually occurs to peripheral nerves?

Answer 16

loss of axons

peripheral nerve demyelination

Question 17

Ix for neuropathy

Answer 17

NCS (nerve conduction study)

EMG (electomyography)

Question 18

give an example of a demyelinating neuropathy

Answer 18

guillan barre

Question 19

how does guillain barre present?

Answer 19

acute onset

sensory symptoms first then paraplegic weakness

Question 20

when do GBS symptoms peak?

Answer 20

10-14 days into weakness

Question 21

Tx of GBS

Answer 21

immunoglobulin infusion or plasma exchange

Question 22

most common mutation that causes hereditary neuropathy

Answer 22

CMT1a

Question 23

do hereditary neuropathies present with sensory or motor symptoms?

Answer 23

they can present with either! can also present with autonomic, small fibre etc

Question 24

causes of axonal neuropathies?

Answer 24

idiopathic
vasculitis esp ANCA +ve
paraneoplastic
infection eg HIV, syphilis
drugs
metabolic eg hypothyroid, diabetes

Question 25

most likely cause of mononeuritis multiplex?

Answer 25

vascultiis

Question 26

what drugs and toxins can cause axonal neuropathies?

Answer 26

alcohol
amiodarone
phenytoin
chemo

Question 27

chronic causes of autonomic neuropathies?

Answer 27

diabetes
amyloidosis
hereditary

Question 28

acute causes of autonomic neuropathy

Answer 28

GBS

porphyria

Question 29

what types of hepatitis can cause an axonal neuropathy

Answer 29

B and C

Question 30

Tx of non-vasculitic axonal neuropathy

Answer 30

treat cause

symptomatic eg physio, pain relief

Question 31

Tx of vasculitic axonal neuropathy

Answer 31

pulsed IV methylprednisolone and cyclophosphamide

Question 32

demyelinating neuropathies can also be called….

Answer 32

inflammatory neuropathies

Question 33

Tx of demyelinating neuropathies

Answer 33

IV Ig
steroids
azathioprine
mycophenalate
cyclophosphamide