Peripheral neuropathy Flashcards

1
Q

What is Charcot-Marie Tooth disease

A

A herditary sensorimotor disorder HSMD
chronic demyelinating disorder of the PNS
Presents in 20s

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2
Q

Features of Charcot Marie Tooth

A
Distal muscle wasting and weakness
Champagne bottle appearance 
pes cavus 
absent reflexes 
loss of sensation
calf muscle atrophy
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3
Q

What is Guillain Barre syndrome (GBS)

A

an acute demyelinating disorder of the PNS

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4
Q

Features of GBS

A

pain very common
acute <4 weeks
symmetrical progressive sensorimotor paralysis
areflexia - lose reflexes
associated with post infectious state eg campylobacter
off legs

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5
Q

What is chronic inflammatory demyelinating polyradiculoneuropathy

A

acquired demyelinating condition of the PNS

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6
Q

what 5 questions should be asked when it comes to identifying peripheral neuropathy disease

A
  1. which nerves are damaged
  2. where are they damaged
  3. how are they damaged
  4. why are they damaged
  5. how to manage this
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7
Q

PNS includes ANS, true or false

A

true

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8
Q

modality and function of motor nerves

A

Aa

muscle control

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9
Q

symptoms of damage to motor nerves

A

muscle weakness and wasting
unsteadiness
reduced power

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10
Q

are reflexes absent or present with motor neuron damage

A

absent

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11
Q

is sensation preserved or diminished in motor neuron damage

A

preserved

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12
Q

modality and function of sensory nerves

A

Aa / AB

fine touch and proprioception

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13
Q

symptoms of damage to sensory nerves

A

reduced vibration and proprioception

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14
Q

is power preserved or diminished in sensory neuron damage

A

preserved

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15
Q

are reflexes absent or present with sensory neuron damage

A

absent

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16
Q

modality and function of small fibres

A

A delta / C

pain and temperature sensation

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17
Q

symptoms of small fibre damage

A

reduced pain and temperature sensation

18
Q

is power preserved or diminished in small fibre damage

A

preserved

19
Q

are reflexes present or absent in small fibre damage

A

present

20
Q

modality and function of autonomic nerves

A

A delta / C

HR, BP, sweating, gut

21
Q

is power preserved in autonomic nerve damage

A

yes

22
Q

is sensation preserved in autonomic nerve damage

A

yes

23
Q

are reflexes present in autonomic nerve damage

A

yes

24
Q

what is pseudoathetosis

A

large fibre sensory neuropathy with damaged joint position sense

25
Q

what is radiculopathy

A

damage to the nerve roots

26
Q

what is plexopathy

A

damage to the plexus

27
Q

what is peripheral neuropathy

A

damage to the nerves distal to plexus

28
Q

what are the types of peripheral neuropathy

A

mononeuropathy
mononeuritis multiplex
length dependent peripheral neuropathy

29
Q

give examples of mononeuropathy

A

carpal tunnel syndrome
cubital tunnel syndrome
common fibular nerve palsy

30
Q

what is mononeuritis multiplex

A

painful, patchy distribution

affects more than 2 isolated nerve areas

31
Q

is mononeuritis multiplex symmetrical

A

NO

does not have rules of symmetry

32
Q

in which conditions in mononeuritis multiplex seen

A

DM
vasculitis
SLE
amyloidosis

33
Q

describe distribution of length dependent peripheral neuropathy

A

glove and stocking distribution
symmetrical
weakness +/or sensory loss

34
Q

how can nerves be damaged

A

axonal loss

peripheral nerve demyelination

35
Q

how can peripheral demyelination be classified

A

acute

chronic

36
Q

examples of acute peripheral demyelinating disease and what is the timescale

A

Guillain Barré syndrome
Acute Inflammatory Demyelinating Polyradiculoneuropathy AIDP
days - weeks

37
Q

examples of chronic peripheral demyelinating disease and what is the timescale

A

Hereditary Sensory Motor neuropathy HSMN aka Charcot Marie Tooth disease
Chronic Inflammatory Demyelinating Polyradiculoneuropathy CIDP
months - years

38
Q

management of GBS

A

IVIG +/or plasma exchange

39
Q

causes of axonal neuropathies

A
idiopathic 
vasculitic 
paraneoplastic 
infections
drugs/toxins 
metabolic
40
Q

causes of autonomic neuropathies

A
DM
amyloidosis 
hereditary 
Guillain Barré 
porphyrias
41
Q

what is the ABCDEE of peripheral neuropathies

A
Alcohol 
B12 / folate deficiency 
Cancer / CKD
Diabetes 
Every vasculitis 
Especially ANCA and RA
42
Q

which drugs can cause peripheral neuropathy

A

phenytoin
chemotherapy - cisplatin/vincristine
alcohol
amiodarone