Polyneuropathy Flashcards
What is the difference between + and - neuro symptoms
+= addition to the persons usual o experience, now present symptoms
Pins and needles, sharp pain, tingling, movement disorders
-=decrease i persons usual symptoms like numbness, dysphasia, dysarthria, loss of sensation
What is axonal polyneuropathy
Peripheral that affects the axons
Leads to impaired nerve function, affecting sensory and ,other
Causes: diabates, infections, alcohol, chemo drugs , vit deficiencies
Sensory: numbness, tingling, pins and neeedles,
Motor: weakness, atrophy, coordination issues
Pain, loss of reflexes
Processes : metabolic distrnacnce, toxins or injury can cause mitochondrial dysfunction causing damage axon which degenerate (wallerian degenration) and axon dies
What is demyelination pneuropathy
Peripheral where the myelin sheath is damaged or destroyed
Causes: Guillian barre syndrome triggered by infection where autominne disorder
Can affect people and cause respiratory failure within hours
Ascending
How are some neuropathy ascending and some descending
Ascending begins distal and progressively moves proximal to upper body
Causes: guillian- barre syndrome which is an acute autoimmune disorder starts with weakness and tingling in feet
Chronic inflammatory demyelination poly
Die tic neuropathy
Demyelination or axonal damage in the peripheral nerves, typically in the lower limbs, causes the motor and sensory symptoms to begin distally Demyelination or axonal damage in the peripheral nerves, typically in the lower limbs, causes the motor and sensory symptoms to begin distally
Descending: begin in proximal areas and descend towards distal parts
Brain or spinal cord disorders: Conditions affecting the brain or spinal cord can cause descending neuropathy. For example, conditions like myasthenia gravis or poliomyelitis (polio) can start with muscle weakness or paralysis in the upper body, which then progresses downward.
Brainstem infovement
Progressive Neurological Disorders: Some diseases like amyotrophic lateral sclerosis (ALS) or multiple sclerosis (MS) can cause symptoms that start in the upper body (descending) before moving downward
What is mixed polyneuropathy
Where both types of nerves are affected such as motor, sensory and autonomic
Both sensory and motor nerve affected
Immune-mediated process. Rare.
Acute hours to days
Common causes:
Diabetes,
GBS
Chronic inflamoprty demyelination polyneuropathy
Inherited]
Toxins or meds like chemi
Weakness distally, muscle atrophy, reduced reflex, loss of coordination
Hypersensitivity to touch
Most are ascending
Why are neuropathy’s often length dependant, why does it not starter proximally ?
More violent lane consisting of sensory and motor nerves
Longer distance to travel more suspetible to external envrroment, making them prone to demyelination or axonal damage
Myelin sheath vulnerabilities due to length requiring more metabolic resources to maintain
Systemic conditions like diabetes, toxins or chemo affect nerve metabolism or blood supply.
In diabetic neuropathy, for example, the microvascular blood supply to peripheral nerves is often impaired.
Longer AP travel distance
Proximal nerves are more compact and have more efficient blood supply, less vulnerable to nerve health like diabetes, chemo or toxins
What is length dependent polyneuropathy
Type of peripheral neuropathy where the longer nerve fibres are affected in gradual progression
Often distally and ascending
Symmetrical
Distal distribution
Sensorimotor involvement
Diabetes, chemo, alcogo, inheritance, toxins or heavy metals,
What is acquired polyneuropathy
where multiple peripheral nerves are damaged or dysfunctional due to external factors or conditions that develop over time, rather than being inherited
diabetes, auotimme, infections , toxins and meds, nutritional deficincies, chronic kidney disease, vasculitis, trauma, cancer, idiopathic
What are causes of polyneuropathies
metabolic and endocrine disorders like diabetes: high blood sugar damage nerves
hypothyroidism: low thyroid hormone
chronic kidney disease: toxins
toxic and chemical causes: alcohol abuse, chemo, heavy metal poison, chemicals
autoimmune disease: Guillain-Barré Syndrome (GBS): A rapid-onset autoimmune disorder where the body’s immune system attacks peripheral nerves.
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP): A long-term autoimmune condition that causes progressive weakness and sensory loss.
Lupus and rheumatoid arthritis
infections: HIV/AIDS
Hep C, Lyme disease, leprosy, shingles
Genetic disorders
Nutritional deficiencies: lack of B12, B1, E
trauma and compression
inflammatory condition like vasculitis
idiopathic
what is a polyneuropathy
multiple peripheral nerves are damaged leading to weakness, numbness and pain especially distally
what is the difference between acquired and hereditary polyneuropathy
acquired is due to external factors that develop over timr
cure or managed
hereditary is genetic mutations passed through families.
Charcot-Marie-Tooth disease (CMT), which involves mutations affecting nerve function and structure, leading to progressive nerve damage.
no cure
what are Sensory Neuropathies (Ganglionopathy).
type of peripheral neuropathy that affects sensory nerves which affect touch, pain, temp and proprioception
sensory ganglia are affected and damaged. often is damaged in DORSAL ROOT GANGLIA which are responsible for transmitting signals from body to CNS
symptoms: numbness, tingling (parasthesia), burning, loss of sensation, balance problems, loss of sensation
idioptatuc, autoimmune like BS or CIDP, infections like HIV, metabolic diseases like diabetes or vitamin deficiencies B12!, vasculitis
the tracts that are affected are dorsal columns (posterior) which is rspobsle for fine touch, proprioception and vibration, coordination and balance
Spinothalamic tract: pain, temp, crude touch
Spinocerebrlar: unconscious proprioception
Length-Dependant vs Multifocal nerves
length dependent is mc and is gradual, progressive and distal to proximal. long affects because it is more vulnerable
causes: diabets, kidney disease, alcohol nurpathy, B12, toxins.
Symptoms:
Symmetrical, tingling, numbness, pain distally , motor symptoms and starts distally
Multifocl is multiple, discrete nerve areas in different parts of the body, often without following the typical distal-to-proximal. specific nerves or nerve groups, which may not necessarily be related by their length.
focal nerve inflammation or ischamic damage, can be immune mediates, vascular issues
Treatable
symptoms:
asymmetrical, motor disfunction, sensory changes, pain
what is Chronic Inflammatory Demyelinating Polyradiculoneuropathy
Rare
chronic autoimme disorder which involves demyelination of peripheral nerves and nerve roots. autoimme
Progressive weakness and sensory loss
immune attacks myelin sheath
ypically inflammatory and autoimmune, with the body’s immune system targeting the nerve roots
symptoms: weakness , atrophy
numbness, proprioception , decreased deep tendon reflexes
autonomic dysfunction
Alcoholism how it affects nerves
alcoholic neuropathy where the nerves are damaged due to the toxins.
alcohol depresses the CNS impairing brain function. It affects neurotransmitters like gamma-aminobutyric acid (GABA), which is inhibitory, and glutamate, which is excitatory. This imbalance can alter mood, memory, and cognitive functions, leading to difficulty concentrating, memory loss, and mental fog.
GABA reduction causes increased nerve excitability
Glutamate increase causes neurotoxicity
Dopaine receptor activity alters leading to addiction which impairs brains ability to naturally respond
it damages the cerebellum which is responsible for coordination and balance leading t problems with motor control like gait
PERIPHERAL can cause alcohol polyneuropathy t can cause damage to the myelin sheath affecting the peripheral nerves. can affect oligodendrocytes
chronic alcohol consumption can activate the microglia, the immune cells of the brain. These cells release pro-inflammatory cytokines and other molecules that can lead to neuroinflammation, which damages neurons and synaptic connections
sympathetic (fight or flight) and parasympathetic (rest and digest) dysfunctions, resulting in irregular heartbeats, changes in blood pressure, and digestive problems.
brain shrinkage (atrophy), particularly in areas such as the frontal cortex, hippocampus, and cerebellum. The frontal cortex is important for higher cognitive functions, while the hippocampus is involved in memory.
Diabetic Autonomic Neuropathy
Nerve damage that affects autonomic nervous system. HR, BP, digestion, Band B, sweating, sex
chronic hyperglycemia (high blood sugar) over a long period
damage to small blood vessels and poor blood flow and oxygen delivery is damaged. especially in autonomic fibres which control involuntary functions like blood pressure
advanced glycation end products form inflammation and damage to nerve tissues
symptoms: postural hypotension, restin tachycardia, exercise intolerance , constipatia, dysphagia, ED, sweating abnormalities, Pupillary Abnormalities
Diabetic Amyotrophy
RARE
nerve damage in lumbosacral plexus which affects hips, thighs, legs
Leads to sudden, severe pain followed by muscle weakness and wasting. Mc thighs, hips, buttocks
Muscle waste, weight loss, can spread to other leg
hyperglycaemia causes microvascular damage, inflammation and metabolic changes
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muscle wekanes
sensory change
leg weakness
unilateral or bilateral
weight loss
what is Hereditary Neuropathy with Liability to Pressure Palsies (HNPP)
RARE
predisposition to nerve damage due to mild physical pressure or compression on nerves
temporary muscle weakness, numbness or paralysis
‘pressure palsies’
genetic mutation in gene which functions myelin
abnormal myelin formation, making the nerves more vulnerable to damage, particularly from mechanical pressure or compression
sudden oset
reocuring
mc wrist , elbow, shoulder, knee, hip and thigh or face
what is Charcot-marie- tooth
group of inherited neurological disorders that affect the peripheral nerves
Especially those controlling muscle of feet, lower leads, hands forearms.
Usually start childhood or YA. Slow
Muscle weakness
Foot deformities like high arch or hammer toe
Difficulty walking
Loss of sensation
Hand weakness
Decreased reflex
common 1 in 2,500
progressive muscle weakness, atrophy and sensory loss primarily distal
type 1= demylnation
type 2= axonal degenerative
deformities, contractures, gait and balance problems
what is Hereditary Neuralgic Amyotrophy (HNA)
RARE
Sudden nerve px, muscle atrophy and weakness
brachial plexus mc
neuralgic amyotrophy reoccurent, sever pain and weakness in muscles of upper extremities
multiple episodes over time
genetic mutation causes demyelination or axonal degeneration
dominant gene
sudden onset sever px
muscle wekaness
muscle atrophy
paralysis and reduced reflexes
reoccurent episodes
assymtery
what is Familial Amyloid Polyneuropathy (FAP)
RARE
progressive degeneration of peripheral nerves
amyloidosis (abnormal proteins) accumulate in tissues and organs. they affect nerves but can affect heart and kidneys
dominant gene
pain
motor symptoms
senosry symptoms
autonomic dysfunction
genetic testing, biopsy
how does a b12 deficiency affect polyneuropathies
it helps form myelin
essential for nerve function, DNA synthesis
when b12 low it cases nerve damage especially peripheral as it impairs synthesis of myelin
numbness tingling
burning
atxaxia
cognitive decline
autonomic issues
motor issues
what is hereditary neuralgic amyotrophy
Causes episodes of intense nerve px followed by muscle weakness ans atrophy
Mc upper body
Genetic mutation
what is Gillian barre syndrome
autoimmune disorder where immune system attacks peripheral nervous system
attack meeykin sheath
usually begin lower lombs
weakness and paralysis
tingling or numbness
loss of reflex
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facial wekaness
breathing difficulties
autonomic dysfunction
Caused by Epstein Barr, covid, bacterial infection , flu vaccine,
