Peripheral neuropathy -Aversano

Question 1

What are some signs and symptoms of neuropathic injury?

Answer 1

-distal to proximal weakness
-atrophy
cramping with fatigue
decreases/absent reflexes
-decreased or loss of sensation
-paresthesias (pins and needles)
-dysesthesias (unpleasant sensations)

Question 2

What will a dysfunction of larger nerve cause? smaller fibers?

Answer 2

decrease in position/vibration for larger

smaller: decrease in pain or temperature

Question 3

How are neuropathies diagnosed?

Answer 3

physical exam
EMG/nerve conduction studies
H reflex/F-responses

Question 4

S/S of Acute inflammatory polyradiculoneuropathy

Answer 4

• Guillain Barre Syndrome
• 1.5/100,000
• Preceded by infection
• aniganglioside antibodies( GM1, GD1A)
• ascending progressive weakness
• areflexia
• high CSF protein and low WBC
• may involve CNs and respiration,
• recovery in most
• hours to days
• mild sensory loss
• axonal loss=slower recover
• can have autonomic instability

Question 5

How do you treat GBS?

Answer 5

IVIG

plasmapheresis

Question 6

What is the most common cause of neuropathy?

Answer 6

diabetic neuropathy

Question 7

What are some symptoms of CMT?

Answer 7

• hereditary motor sensory neuropathy
• gradual, progressive distal weakness atrophy and sensory loss over years
• foot drop
• hammer toe and pes cavus
• autosomal dominant
• sx begin in early adulthood
• enlarged palpable peripheral nerves (esp auricular N)
• severely slowed NCS on EMG

Question 8

What can cause entrapment neuropathies?

Answer 8

• Carpal tunnel syndrome (at the wrist under the flexor retinaculum)
• ulnar neuropathy (at the elbow)
• radial n palsy (saturday night palsy) (compress at the humerus)
• peroneal neuropathy (present with foot drop)
• lateral femoral cutaneous n syndrome (meralgia paresthetica) (runs over the head of the ASIS)
• tarsal tunnel syndrome