PNS clinical correlates

Question 1

Guillain-Barre Syndrome (GBS) is what?

Answer 1

demyelination of peripheral axons which begins several weeks following a GI or respiratory infection (due to an autoimmune response)

Question 2

Respiratory support is often needed in GBS until what?

Answer 2

schwann cells can successfully re-myelinate the nerves

Question 3

can patients recover from peripheral neuropathy in GBS?

Answer 3

YES

Question 4

what treatment can be used in GBS peripheral neuropathy?

Answer 4

IV immune globulin

Question 5

what is leprosy (hansen disease) caused by?

Answer 5

mycobacterium leprae

Question 6

what is the most common treatable neuropathy worldwide?

Answer 6

leprosy (hansen disease )

Question 7

once the bacteria enters the body through the skin what does the organism preferentially gain assess to?

Answer 7

unmyelinated axons

Question 8

what are some symptoms associated with leprosy (hansen disease)

Answer 8

skin lesions and profound sensory loss (TP) due to ischemia/compression of the peripheral nerves

Question 9

what treatments are used for leprosy (hansen disease)

Answer 9

antibiotics

Question 10

who are most susceptible to lead poisoning?

Answer 10

children because their brain and CNS are not fully developed

Question 11

Lead traces in the blood can lead to what conditions?

Answer 11

encephalopathy with diminished IQ, attentional problems, and learning disabilities. Higher levels can result in mental retardation, coma or death

Question 12

what are some symptoms of lead poisoning?

Answer 12

distal muscles more than proximal
(bilateral arm weakness and wasting, motor neuropathy, and focal weakness of extensor muscles of fingers, wrist and arms)

Question 13

Is sensory affected in lead poisoning?

Answer 13

NO

Question 14

how can you distinguish a UMN syndrome from lead poisoning?

Answer 14

loss of muscle mass (remember that atrophy is associated with LMN syndrome)

Question 15

what is alcoholic polyneuropathy caused by?

Answer 15

neurotoxic effects of alcohol associated malnutrition (Vitamin B1 –> thiamin deficiency)

Question 16

what symptoms are associated with alcoholic polyneuropathy?

Answer 16

sensory loss in lower legs and progresses to motor losses in the legs

Question 17

is nerve conduction normal in patients with alcoholic polyneuropathy?

Answer 17

yes

Question 18

Alcoholism of about how many years establishes a high risk for alcoholic neuropathy?

Answer 18

10 + years

Question 19

Diabetic neuropathy is usually seen in what kind of diabetics?

Answer 19

insulin dependent

Question 20

what kind of symptoms are seen?

Answer 20

1) Autonomic (dry skin)
2) Motor (usually asymmetric)
3) Sensory ( usually symmetric)

Question 21

Sensory symptoms for a diabetic usually begin in both legs, this loss reflects what?

Answer 21

losses reflect abnormalities of unmyelinated axons carrying pain and temperature in a stocking distribution

Question 22

What structures are very vulnerable to hyperglycemia?

Answer 22

DRG and unmyelinated axons

Question 23

how does this problem of high vulnerability to sugar come about?

Answer 23

this may be due to lack of nutrient and protein supply to distant parts

Question 24

what does NCV, EMG and CSF show for Guillian-barre syndrome?

Answer 24

NCV–> sensitive to demyelination (conduction of impulses through the nerve slows or is blocked)
EMG–> lack of nervous stimulation
CSF–> sometimes elevated protein