Peripheral Neuropathy Flashcards
Define neuropathy
any pathological process affecting nerves
Define mononeuropathy
any pathological process affecting single nerves
Define mononeuritis multiplex
pathological process where where several individual nerves are affected
Define polyneuropathy
pathological process where there is diffuse symmetrical involvement of nerves usually commencing peripherally
Define radiculopathy
disease affecting the nerve roots
Define plexopathy
disease affecting the brachial or lumbosacral plexus
Describe the symptoms that may be experienced if a large motor nerve fibre was affected by neuropathy?
weakness, unsteadiness, wasting
reduced power
absent reflexes
normal sensation
Describe the symptoms that may be experienced if a large sensory nerve fibre was affected by neuropathy?
numbness, paraesthesia, unsteadiness
normal power
vibration and joint position sense reduced
absent reflexes
Describe the symptoms that may be experienced if a small sensory nerve fibre was affected by neuropathy?
pain, dysesthesia (not normal sensations)
normal power
pin prick sensation and temperature reduced
reflexes present
Describe the symptoms that may be experienced if autonomic nerve fibres were affected by neuropathy?
dizziness (postural hypotension), impotence, nausea and vomiting (gastroparesis)
normal power
normal sensation
present reflexes
Describe the pattern of distribution of most peripheral poly neuropathies?
most are length dependent affecting the longest nerves first so symptoms tend to be found in a glove and stocking distribution
Describe the pattern of distribution of a radiculopathy?
changed sensation in the dermatome, altered movement in the myotome corresponding to that nerve root
Describe the pattern of distribution of a plexopathy?
distribution in a whole limb
Describe the pattern of distribution of mono-neuritis multiplex?
symptoms with patchy distribution of peripheral nerves, ie may be ulnar nerve area affected and common perineal nerve area affected
List some broad causes of damage to peripheral nerves?
demyelination
compression
diabetes
systemic or autoimmune diseases
What is the most common acute peripheral nerve demyelinating disorder?
Guillan Barre Syndrome
Describe symptoms of Guillan Barre Syndrome?
Progressive paraplegia over days up to 4 weeks, sensory symptoms proceed weakness, pain is common, can result in paralysis
What is thought to cause GBS?
usually follows 1-3 weeks after a trivial and seldom identified infection e.g. campylobacter infection or CMV
How is diagnosis of GBS confirmed?
nerve conduction studies
How is GBS treated?
immunoglobulin infusion and or plasma exchange
Name 3 peripheral demyelinating disorders?
guillan barre syndrome
chronic inflammatory demyelinating polyradiculopathy
hereditary neuropathies
When should hereditary neuropathies be considered?
in young people present with a neuropathy
Name some common compression neuropathies?
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)
What disease can cause many different patterns of neuropathies?
diabetes
Name some systemic/ autoimmune diseases that can cause neuropathies?
lupus
vasculitis
sarcoidosis
infection
