Peripheral Neuropathy Flashcards

1
Q

Name all areas that are considered part of the peripheral nervous system, starting with the nerve root and working out towards the muscle?

A
nerve root
spinal nerve
rami
plexus
peripheral nerve
NMJ
muscle fibres
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Symptoms of peripheral neuropathy are related to the type of nerve fibres involved. TRUE/FALSE?

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Damage to what type of fibres causes motor symptoms?

A

A-alpha

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What symptoms are present if A-alpha fibres (large motor) are damaged?

A

Weakness
Unsteadiness
Muscle wasting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What fibres are considered large sensory fibres?

A

A-alpha and A-beta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What symptoms are present if large sensory fibres are dmamaged?

A

numbness
parasthesia
unsteadiness
lack of proprioception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do small A delta and C fibres control?

A

pain
temperature regulation
autonomic functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What symptoms can be seen if a-delta and c fibres are damaged?

A

pain
dysethesia

autonomic symp: dizzy, N+V, impotence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What areas of the peripheral nervous system can be damaged to cause a neuropathy?

A

Nerve Root => radiculopathy
Plexus => Plexopathy
Peripheral Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the different categories of peripheral nerve neuropathy?

A

=> Mononeuropathy (one named nerve)
=> Mononeuritis Multiplex (patchy distribution)
=> (length dependent) Peripheral Neuropathy (usually bilateral and driven by illness e.g. diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is a (length dependent) Peripheral Neuropathy usually distributed across the body?

A

weakness and or sensory loss in glove and stocking distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What should you always check if you notice muscle wasting in a patient and assume they have a mononeuropathy?

A

Check if muscle is wasted on opposite side of body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the most common cause of mononeuritis multiplex and why does it cause this?

A

Vasculitis (usually ANCA +ve)

Blood supply to the nerve gets lost in disease process
=> patients have acute loss of function
=> patchy distribution of loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What plexopathy is common in newborn babies?

A

Erb’s Palsy

  • damage of C5,6 during childbirth when baby’s neck is pushed to side during difficult delivery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the two main ways in which nerves can be damaged in a peripheral neuropathy?

A

Axonal Loss

Demyelination (NOT MS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How can we distinguish whether a peripheral neuropathy has been caused by axonal loss or by demyelination?

A

Neurophysiology

- each gives very distinct signal

17
Q

What demyelinating disorders of the PNS are ACUTE?

A

Guillain Barre syndrome (GBS)

Acute Inflammatory Demyelinating Polyneuropathy (AIDP)

18
Q

WHat demyleinating disorders of the peripheral NS are chronic?

A

Chronic inflammatory demyelinating polyradiculopathy (CIDP)

Hereditary sensory motor neuropathy (formerly Charcot-Marie-Tooth disease)

19
Q

How does Guillain-Barre syndrome usually present?

A
  • Progressive paraplegia over days up to 4 weeks
  • Associated sensory symptoms before weakness
  • Pain very common
20
Q

At what day during Guillain-Barre syndrome are symptoms usually at their peak?

A

Day 10-14

21
Q

Examination can be normal in the initial phases of Guillain-Barre syndrome. TRUE/FALSE?

A

TRUE

22
Q

What infection is thought to potentially precipitate guillain-barre syndrome?

A

Campylobacter

23
Q

What causes the mortality associated with Guillain-barre syndrome?

A

Autonomic nerves become affected and cause life threatening symptoms e.g. cardiac arrhythmias

24
Q

What treatment is used for guillain-barre syndrome?

A

immunoglobulin infusion and or Plasma exchange

25
Q

Hereditary neuropathies are usually genetic. TRUE/FALSE?

A

TRUE

Lots of varieties of hereditary neuropathies, but one of the most common mutations = CMT1a

26
Q

How are hereditary sensory motor neuropathies normally noticed clinically?

A

Longstanding loss of muscle (especially tibial)
pes planus
thin distal musculature
joints not well formed due to disease since childhood

27
Q

What are the main causes of axonal neuropathies?

A
Idiopathic (age related)
Vasculitic
Paraneoplastic
Infections
Drugs/Toxins
Metabolic
28
Q

What conditions can cause a chronic autonomic neuropathy?

A

Diabetes

Amyloidosis

29
Q

What conditions can cause an acute autonomic neuropathy?

A

Guillain-Barre (this is the cause of mortality in this condition)

Porphyrias

30
Q

How are axonal peripheral neuropathies treated?

A

Treat cause (ie treat infection etc)

Symptomatic treatment – physiotherapy, neuropathic pain relief.

If inflammatory vasculitis - steroids and immunosuppression

31
Q

How are demyelinating peripheral neuropathies treated?

A

IV Immunoglobulin
Steroids
Immunosuppression