Polyneuropathy Flashcards
1
Q
Classification of diabetic neuropathy
A
Sensory - glove and stocking distribution, loss of vibration sensation
Motor - clawing of toes, charcot’s arthropathy, LMN signs
Autonomic - postural drop, gastroparesis
2
Q
Causes of polyneuropathies
A
ABCDEFGH: Alcohol B12 deficiency Chemo (vincristine) Diabetes and drugs (isoniazid) Every vasculitis (polyarteritis nodosum, granulomatosis with polyangitis) Familial (Charcot-Marie-Tooth) Guillian-Barre syndrome HIV
3
Q
What is guillian-barre syndrome
A
Acute onset of symmetrical demyelination of peripheral nerves leading to progressive neuropathy
4
Q
Triggers of guillian-barre syndrome
A
Campylobacter jejuni
EBV
CMV
5
Q
Symptoms of guillian-barre syndrome
A
Muscle weakness progressing from feet upwards Glove and stocking sensory loss Hyporeflexia Hypotonia Neuropathic pain Type 2 respiratory failure Autonomic (constipation, decreased urinary frequency) Gait disturbance - foot drop Speech disturbance - poor articulation
6
Q
What is Charcot Marie Tooth disease
A
Autosomal dominant symmetrical progressive polyneuropathy with: Muscle weakness from feet upwards Lipodermatosclerosis High medial foot arches Clawing of toes Muscle wasting Loss of dorsal column modalities
7
Q
Investigations for guillian-barre syndrome
A
FBC CRP U+Es LFTs Clotting CXR Anti-AChR Anti-MuSK EMG LP- high protein
8
Q
Management of guillian-barre syndrome
A
Analgesia for neuropathic pain IV Ig/ plasmapheresis Corticosteroids to prevent relapses Prophylaxis for VTE and pressure sores Bowel and bladder care \+/- ventilation
