Peripheral Neuropathy

Question 1

Define neuropathy

Answer 1

any pathological process affecting nerves

Question 2

Define mononeuropathy

Answer 2

any pathological process affecting single nerves

Question 3

Define mononeuritis multiplex

Answer 3

pathological process where where several individual nerves are affected

Question 4

Define polyneuropathy

Answer 4

pathological process where there is diffuse symmetrical involvement of nerves usually commencing peripherally

Question 5

Define radiculopathy

Answer 5

disease affecting the nerve roots

Question 6

Define plexopathy

Answer 6

disease affecting the brachial or lumbosacral plexus

Question 7

Describe the symptoms that may be experienced if a large motor nerve fibre was affected by neuropathy?

Answer 7

weakness, unsteadiness, wasting
reduced power
absent reflexes
normal sensation

Question 8

Describe the symptoms that may be experienced if a large sensory nerve fibre was affected by neuropathy?

Answer 8

numbness, paraesthesia, unsteadiness
normal power
vibration and joint position sense reduced
absent reflexes

Question 9

Describe the symptoms that may be experienced if a small sensory nerve fibre was affected by neuropathy?

Answer 9

pain, dysesthesia (not normal sensations)
normal power
pin prick sensation and temperature reduced
reflexes present

Question 10

Describe the symptoms that may be experienced if autonomic nerve fibres were affected by neuropathy?

Answer 10

dizziness (postural hypotension), impotence, nausea and vomiting (gastroparesis)
normal power
normal sensation
present reflexes

Question 11

Describe the pattern of distribution of most peripheral poly neuropathies?

Answer 11

most are length dependent affecting the longest nerves first so symptoms tend to be found in a glove and stocking distribution

Question 12

Describe the pattern of distribution of a radiculopathy?

Answer 12

changed sensation in the dermatome, altered movement in the myotome corresponding to that nerve root

Question 13

Describe the pattern of distribution of a plexopathy?

Answer 13

distribution in a whole limb

Question 14

Describe the pattern of distribution of mono-neuritis multiplex?

Answer 14

symptoms with patchy distribution of peripheral nerves, ie may be ulnar nerve area affected and common perineal nerve area affected

Question 15

List some broad causes of damage to peripheral nerves?

Answer 15

demyelination
compression
diabetes
systemic or autoimmune diseases

Question 16

What is the most common acute peripheral nerve demyelinating disorder?

Answer 16

Guillan Barre Syndrome

Question 17

Describe symptoms of Guillan Barre Syndrome?

Answer 17

Progressive paraplegia over days up to 4 weeks, sensory symptoms proceed weakness, pain is common, can result in paralysis

Question 18

What is thought to cause GBS?

Answer 18

usually follows 1-3 weeks after a trivial and seldom identified infection e.g. campylobacter infection or CMV

Question 19

How is diagnosis of GBS confirmed?

Answer 19

nerve conduction studies

Question 20

How is GBS treated?

Answer 20

immunoglobulin infusion and or plasma exchange

Question 21

Name 3 peripheral demyelinating disorders?

Answer 21

guillan barre syndrome
chronic inflammatory demyelinating polyradiculopathy
hereditary neuropathies

Question 22

When should hereditary neuropathies be considered?

Answer 22

in young people present with a neuropathy

Question 23

Name some common compression neuropathies?

Answer 23

carpal tunnel syndrome (median nerve)
Cubital tunnel syndrome (ulnar nerve)
radial nerve at the humerus
Common peroneal nerve palsy (compression at the head of the fibula)

Question 24

What disease can cause many different patterns of neuropathies?

Answer 24

diabetes

Question 25

Name some systemic/ autoimmune diseases that can cause neuropathies?

Answer 25

lupus
vasculitis
sarcoidosis
infection