Polyneuropathy Flashcards
What is polyneuropathy?
Damage or disease affecting peripheral nerves in roughly the same areas on both sides of the body
What are the features of polyneuropathy?
- Weakness
- Numbness
- Burning pain
Where does polyneuropathy usually begin?
In the hands and feet
Where can polyneuropathy progress to from the hands and feet?
- Arms and legs
- Sometimes other parts of the body
How many main patterns of polyneuropathy are there?
3
What are the 3 patterns of polyneuropathy?
- Acute symmetrical peripheral neuropathy
- Chronic symmetrical peripheral neuropathy
- Multiple mononeuropathy
What can the causes of polyneuropathy be divided into?
- Inherited causes
- Acquired causes
What are the inherited causes of polyneuropathy?
- Charcot-Marie-Tooth disease
- HNPP
What are the acquired causes of polyneuropathy?
- DM
- Vascular neuropathy
- Alcohol abuse
- Vitamin B12 deficiency
What types of symptoms can patients with polyneuropathy experience?
- Altered sensation
- Pain
- Weakenss
- Autonomic symptoms
What part of the body is usually affected first in sensory polyneuropathy?
Feet
What are some features of sensory polyneuropathy?
- Paraesthesia
- Numbness
- Burning pain
- Loss of vibration sense and position sense
- Muscle wasting
What are some symptoms of autonomic polyneuropathy?
- Constipation
- Loss of bowel and bladder control
- Orhtostatic hypotension
- Pale and dry skin with reduced sweating
What are some potential features seen in hereditary polyneuropathy?
- Hammer toes
- High arches
- Scoliosis
What should be assessed when taking a history and examination of a patient with polyneuropathy?
- Pattern of disease
- If symptoms fluctuate
- Deficits
- Any pain
How is a diagnosis of polyneuropathy often made?
Clinically
What investigations may be useful in diagnosing polyneuropathy?
- Electrodiagnostic testing
- Serum protein electrophoresis
- Nerve conduction testing
- Urinalysis
- Serum CK
- Antibody testing
What are the differentials for polyneuropathy?
- Toxins
- Guillan-Barre Syndrome
- Lyme disease
- Hepatitis C
- Amyloidosis
- Acromegaly
- Kidney failure
What does management of polyneuropathy depend on?
Underlying cause
What general management is advised in polyneuropathy?
- Lose weight
- Use a walking aid
- Occupational therapy
What are the potential complications of polyneuropathy?
- Disability
- Isolation
- Loss of independence
- Recurrent injuries
- Permanent joint destruction
What causes the recurrent joint injury and destruction in polyneuropathy?
Loss of sensation
What is the joint destruction in polyneuropathy called?
Charcot joint
