Peripheral Neuropathy Flashcards
are reflexes absent in large or small fibre neuropathies?
large
damage to what nerve fibres will cause loss of power in PN
large motor fibres
symptoms of large fibre motor PN
weakness
unsteadiness
muscle wasting
what fibres tend to cause numbness and paraesthesia
large sensory fibres
symptoms of large fibre sensory PN
numbness
paraesthesia
unsteadiness
what sensations are reduced in large fibre sensory PN
vibration
proprioception
what sensations are reduced in small fibre PM
pin prick
temperature
symptoms of small fibre PN
pain
dyesthesia
what is dyesthesia?
an abnormal unpleasant sensation felt when touched
symptoms of autonomic PN
postural hypotension
impotence
N+V from gastroparesis
power and sensation are normal in autonomic PN T or F
T
define pseudoathetosis
abnormal writhing movements, usually of the fingers, caused by failed proprioception
a radiculopathy relates to damage to a nerve where?
nerve root
what pattern does PN tend to present in
stocking glove pattern
legs affected THEN finger tingling
mononeuritis multiplex has what distribution?
right half of both palms
right half of RIGHT anterior leg
what damage actually occurs to peripheral nerves?
loss of axons
peripheral nerve demyelination
Ix for neuropathy
NCS (nerve conduction study)
EMG (electomyography)
give an example of a demyelinating neuropathy
guillan barre
how does guillain barre present?
acute onset
sensory symptoms first then paraplegic weakness
when do GBS symptoms peak?
10-14 days into weakness
Tx of GBS
immunoglobulin infusion or plasma exchange
most common mutation that causes hereditary neuropathy
CMT1a
do hereditary neuropathies present with sensory or motor symptoms?
they can present with either! can also present with autonomic, small fibre etc
causes of axonal neuropathies?
idiopathic vasculitis esp ANCA +ve paraneoplastic infection eg HIV, syphilis drugs metabolic eg hypothyroid, diabetes
most likely cause of mononeuritis multiplex?
vascultiis
what drugs and toxins can cause axonal neuropathies?
alcohol
amiodarone
phenytoin
chemo
chronic causes of autonomic neuropathies?
diabetes
amyloidosis
hereditary
acute causes of autonomic neuropathy
GBS
porphyria
what types of hepatitis can cause an axonal neuropathy
B and C
Tx of non-vasculitic axonal neuropathy
treat cause
symptomatic eg physio, pain relief
Tx of vasculitic axonal neuropathy
pulsed IV methylprednisolone and cyclophosphamide
demyelinating neuropathies can also be called….
inflammatory neuropathies
Tx of demyelinating neuropathies
IV Ig steroids azathioprine mycophenalate cyclophosphamide
