Peripheral Neuropathy Flashcards Preview

Neurology > Peripheral Neuropathy > Flashcards

Flashcards in Peripheral Neuropathy Deck (37):
1

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

nerve root
spinal nerve
rami
plexus
peripheral nerve
NMJ
muscle fibres

2

symptoms of peripheral neuropathy are related to the type of nerve fibres involved - true or false?

true

3

damage to what type of fibres causes motor symptoms?

a-alpha

4

what symptoms are present if a-alpha fibres (large motor) are damaged?

weakness
unsteadiness
muscle wasting

5

what fibres are considered large sensory fibres?

a-alpha and a-beta

6

what symptoms are present if large sensory fibres are damaged?

numbness
parasthesia
unsteadiness
lack of proprioception

7

what do small A delta and C fibres control?

pain
temperature regulation
autonomic functions

8

what symptoms can be seen if a-delta and C fibres are damaged?

pain
dysethesia

autonomic symptoms = dizziness, nausea, vomiting, impotence

9

where does posterior primary ramus signal to?

back of neck and trunk

10

where does anterior primary ramus signal to?

limbs: anterior and lateral trunk

11

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

nerve root = radiculopathy

plexus = plexopathy

peripheral nerve

12

what are the different categories of peripheral nerve neuropathy?

mononeuropathy (one named nerve)

mononeuritis multiplex (patchy distribution)

length dependent peripheral neuropathy (usually bilateral and driven by illness)

13

how is a length dependent peripheral neuropathy usually distributed?

weakness and or sensory loss in glove and stocking distribution

14

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

check if muscle is wasted on opposite side of body

15

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

vasculitis (usually ANCA +ve)

blood supply to nerve gets lost in disease process - acute loss of function and patchy distribution

16

what plexopathy is common in newborn babies?

Erbs palsy - damage of C5,6 during childbirth when baby's neck is pushed to side during delivery

17

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

axonal loss
demyelination (not MS)

18

how can you distinguish whether a peripheral neuropathy has been caused by axonal loss or demyelination?

neurophysiology - each gives very distinct signal

19

what demyelinating disorders of PNS are acute?

gulliane barre syndrome (GBS)

acute inflammatory demyelinating polyneuropathy (AIDP)

20

what demyelinating disorders of PNS are chronic?

chronic inflammatory demyelinating polyradiculopathy (CIDP)

hereditary sensory motor neuropathy (formerly charcot-marie-tooth disease)

21

how does GBS usually present?

progressive paraplegia over days up to 4 weeks
associated sensory symptoms before weakness
pain very common

22

at what day during GBS are symptoms usually at peak?

day 10-14

23

examination can be normal in initial phases of GBS - true or false?

true

24

what infection is thought to potentially precipitate GBS?

campylobacter

25

what causes the mortality associated with GBS?

autonomic nerves become affected and this causes life threatening symptoms eg cardiac arrhythmias

26

what is treatment for GBS?

immunoglobulin infusion and / or plasma exchange

27

hereditary neuropathies are usually genetic - true or false?

true

28

there are lots of varieties of hereditary neuropathies but what is one of the most common mutations?

CMT1a

29

how are hereditary sensory motor neuropathies normally noticed clinically?

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

30

what are the main causes of axonal neuropathies?

idiopathic (age related)
vasculitis
paraneoplastic
infections
drugs/toxins
metabolic

31

what conditions can cause acute autonomic neuropathy?

GBS

porphyrias

32

how are axonal peripheral neuropathies treated?

treat cause (ie if infection etc)

symptomatic treatment - physio, neuropathic pain relief

if inflammatory vasculitis - steroids and immunosuppression

33

how are demyelinating peripheral neuropathies treated?

IV immunoglobulin
steroids
immunosuppression

34

what are paraneoplastic causes of axonal neuropathies?

myeloma
antibody mediated (eg breast cancer)

35

what are infectious causes of axonal neuropathies?

HIV
syphilis
lyme
hepatitis B/C

36

what are drug / toxin causes of axonal neuropathies?

alcohol
amiodarone
phenytoin
chemotherapy

37

what are metabolic causes of axonal neuropathies?

diabetes
B12 / folate deficiencies
hypothyroidism
chronic uremia
porphyria