Peripheral neuropaties Flashcards
Axonotmesis (Class II)
- Causa: Axonal damage due to
blunt trauma for example
- Síntomas Asociados: Loss of continuity and Wallerian
degeneration distally, basal laminal & endoneurial tissue remain intact.
Polyneuropathy (CIDP)
- Causa:
- Síntomas: N/A ?
- Causa:
- Síntomas:
Peroneal Neuropathy (fibular neck)
- Causa: Trauma or compression
of usually both Deep & Superficial peroneal
- Síntomas: Weak ankle dorsiflexion & eversion,
paresthesias, foot dorsum & lateral shin sensory loss.
Large Fiber Neuropathy
- Causa: Disturbance of large fibers
- Síntomas: Loss of position, vibration, touch-pressure sensibility, hypo- or areflexia, LMN involvement (atrophy & hypotonia), sensory ataxia may be
prominent, NO pain.
- Associated with: Toxic substances, axonal metabolism
problem, ischemia
Guillain Barre Syndrome (acute inflammatory demyelination
polyneuropathy)
- Causa: Segmental inflammatory demyelination of
peripheral nerves & edema
- Síntomas: Acute, ascending & symmetric
peripheral neuritis with spontaneous recuperation, progressive motor weakness up to 4 wks, bilateral face weakness, autonomic dysfunction, elevated CSF after 1 wk, respiratory compromise.
- Predisposing factor: RT infection or
gastroenteritis
Cubital Syndrome
- Causa: Ulnar neuropathy at the elbow, entrapment/compression under humeroulnar
arcade by acute trauma.
- Síntomas: Sensory symptoms in 4th & 5th digits
and ulnar aspect of hand, mold weakness of intrinsic hand muscles (lumbricals & interossei) to severe wasting & claw hand deformity (affects grip)
West Nile Virus
- Causa: Viral prodrome (rapid onset)
- Síntomas: Asymmetric weakness, respiratory impairment, areflexia in affected muscles, no sensory loss, elevated CSF & pleocytosis (increased WBC count)
Neuronotmesis (Class III)
- Causa: Separation of the entire nerve including
supportive tissue
- Síntomas asociados: Neuroma formation & aberrant
regeneration is common, axonal regeneration is limited.
Demyelinating Neuropathies
- Causa: Myelin destruction (fast onset, days)
- Síntomas: Generalized weakness, mild sensory
loss, absent DTR’s, ELEVATED CSF
protein, rapid recovery.
Diabetic Neuropathy
- Causa: Alteration in myoinositol caused by hyperglycemia →impairs ATPase
- Síntomas:
- Axonal changes, alterations in conduction velocity
- Sorbitol accumulates in nerve →hypertonic & water accumulation, endoneurial hypoxia, oxidative stress.
- Associated with: Duration of DM, retinopathy, nephropathy, chronic hyperglycemia increases protein
glycosylation → microvascular disease, ischemic
infarcts.
Neuropraxia (Class I):
- Causa: Compression or acute ischemia
- Síntomas: Conduction block w/o axonal
structural changes
Tarsal Tunnel Syndrome:
- Causa: Tibial nerve compression in ankle region under transverse tarsal (lacinate) ligament due to fracture/dislocation of talus, calcaneus or medial malleolus
- Síntomas: Aching, burning, numbness, tingling in
sole of foot, toes & heel Worse at nights or after prolonged standing Sensory loss over plantar surface
Prominent Tinel’s sign.
Chronic Inflammatory Demyelinating
- Causa: Symmetric weakness in proximal &
distal extremities, sensory loss,
areflexia, high CSF
- Síntomas: Demyelination (slow progression)
- treated with: prednisone or IVGG
Axonal Neuropathy
- Causa: Axonal damage (gradual insidious onset affecting distal part first)
- Síntomas: Stocking-glove sensory loss, weakness, tingling, pinprick, decreased or loss of ankle reflexes, NORMAL CSF protein, slow recovery.
