Polyneuropathy and Autonomic neuropathy Flashcards

1
Q

What are metabolic causes of polyneuropathy?

A
  • Diabetes mellitus
  • Uraemia
  • Hepatic disease
  • Thyroid disease
  • Porphyria
  • Amyloid disease
  • Malignancy
  • Refsum’s disease
  • Critical illness
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2
Q

What vitamin deficiencies can cause polyneuropathy?

A
  • B1, 6, 12
  • Nicotinic Acid
  • Drug related neuropathies
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3
Q

What types of neuropathy can occur in diabetes?

A
  • Distal symmetrical sensory neuropathy
  • Acute painful sensory neuropathy
  • Mononeuropathy and mononeuritis multiplex
  • Diabetic amyotrophy
  • Autonomic neuropathy
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4
Q

What investigations would you do in someone with features of polyneuropathy?

A
  • Bloods - FBC, ESR, Glucose, U+Es, LFTs, TSH, B12, ANA, ANCA
  • CXR
  • Urinalysis
  • Consider LP
  • Genetic testing
  • NErve conduction studies
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5
Q

What are features of sensory neuropathy?

A
  • Numbness
  • Paraesthesiae
  • Affects glove/stocking distribution
  • Difficulty handling small objects
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6
Q

Are diabetic and alcoholic neuropathies painful?

A

Yes

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7
Q

What are features of motor neuropathy?

A

Often progressive

  • Weak/clumsy hands
  • Difficulty walking
  • Difficulty breathing
  • Signs of LMN lesion - flaccid, hyporeflexive, wasting, fasciculations
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8
Q

What are infectious causes of polyneuropathy?

A
  • Leprosy
  • HIV
  • Syphilis
  • Lyme disease
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9
Q

What are causes of autonomic neuropathy?

A
  • DM
  • Amyloidosis
  • Guillain-Barre
  • SJogrens
  • HIV
  • Leprosy
  • SLE
  • Toxic
  • Paraneoplastic
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10
Q

What are signs of sympathetic autonomic neuropathy?

A
  • Postural hypotension
  • Decreased sweating
  • Ejaculatory failure
  • Horner’s syndrome
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11
Q

What are features of Parasympathetic autonomic neuropathy?

A
  • Constipation
  • Nocturnal diarrhoea
  • Urinary retention
  • Erectile dysfunction
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12
Q

How would you investigate someone for autonomic neuropathy?

A
  • BP
  • ECG
  • Cystometry
  • Pupils
  • Paraneoplastic antibodies
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13
Q

What spinal condition can occur asa complication of B12 deficiency?

A

Subacute combined degeneration of the cord

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14
Q

What are features of subacute combined degeneration of the cord asa complication of B12 deficiency?

A
  • Numbness/tingling of fingers/toes
  • Distal sensory loss
  • Absent ankle jerks
  • Exaggerated knee jerks
  • Extensor plantars
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15
Q

NOT DO WITH THIS DECK

What is charcot neuropathic joint?

What causes it?

A

Increased rang of mevement (from lost joint proprioception destroys joint, which becomes sweollen and mobile

Causes: tabes dorsalis (syphillus), diabetic neuropathy (ankle), syringomyelia (swollen wrist), paraplegia (hips), leprosy,

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16
Q

NOT TO DO WITH THIS SECTION

What is charcot marie thooth syndrom?

A

Hereditary sensory and motor neuropathy (strong FH supports diagnosis)

17
Q

NOT TO DO WITH THIS SECTION

How does charcot-marie-toothe syndrome present?

A

Starts in puberty with weak legs and foot drop, variable loss of sensation and reflexes

Signs: foot drop, stomping gait, pes cavus (high foot arches), glove and stocking sensory loss

18
Q

NOT TO DO WITH THIS SECTION

Managment charcot marie tooth syndrome

A

Physio, OT, orthopaedic devices