Peripheral Neuropathy Flashcards Preview

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Flashcards in Peripheral Neuropathy Deck (44):
1

does MS cause peripheral neuropathy

no

2

loss of reflexes means a problem where

peripheral nerves- large motor or sensory fibres

3

which type of fibres conduct the slowest

C- unmyelinated

4

what do Aalpha fibres do

motor- muscle control

5

what do large sensory Aalpha/ beta fibres do

touch, vibration, position perception

6

what do thinly myelinated Adelta sensory fibres do

cold perception
pain

7

what do un myelinated C sensory fibres do

warm perception
pain

8

what are the type of autonomic nerve fibres

Adelta- thinly myelinated
C- unmyelinated

9

what are the symptoms when a large motor fibre is affected

weakness, unsteadiness, wasting

10

what are the symptoms when a large sensory fibres is affected

numbness
paraesthesia
unsteadiness

11

what are the symptoms when a small sensory fibre is affected

pain dyesthesia (painful itchy sensation)

12

what are the symptoms when autonomic fibres are affected

dizziness due to postural hypotension
impotence
nausea and vomiting (gastroparesis)

13

what peripheral fibres are affected when there is reduced power

large motor fibres (Aalpha)

14

what fibres are affected when there is reduced vibration and joint position sensation

large sensory (Aalpha/beta)

15

what fibres are affected when there is reduces pin prick and temperature sensation

small sensory fibre (Adelta/ C)

16

what is pseudoathetosis

abnormal writhing movement (usually of the fingers) due to failure of proprioception

17

what does a high stepping gate result from

foot drop due to weakness of ankle dorsiflexion
DDx
-peroneal palsy
-L5 root lesion
-motor neuropathy

18

what is damages in a radiculopathy

nerve root

19

what commonly causes radioculopathy

prolapse
can be inflammatory

20

what is damaged in plexopathy

plexus

21

what is peripheral neuropathy

damage to the nerve distal to the plexus

22

what are the types of peripheral neuropathy

mononeuropathy (single nerve, e.g trauma)
mononeuritis multiplex (progressive sensory or motor deficits in a specific distribution of peripheral nerves caused by systemic illness- vasculitis, hypersensitivity, drugs etc)
length dependent peripheral neuropathy- small fibre
polyneuropathy- symmetrical distribution

23

what is the distribution of length dependent peripheral neuropathy

glove and stocking, usually symmetrical

24

what is the most common type of peripheral neuropathy

length dependent

25

what is symmetrical wasting suggestive of

PN, if asymmetrical less likely

26

what is the pattern of loss in mononeuritis/ mononeuropathy

loose function very quickly (blood supply lost due to inflammation)
asymmetrical
patchy sensory loss

patient can present with e.g. wrist drop/ foot drop

27

what is the pattern of loss in radiculopathy

loss of reflex and muscle function
asymmetrical

28

what most commonly causes a plexoathy

traction injury

29

how can peripheral nerves be damaged

axonal loss
demyelination (not MS)

30

what results from a demyelinating neuropathy

conduction is slowed

31

what causes an acute (days to weeks) demyelinating neuropathy

guillaine barre syndrome

32

what causes a chronic (months to years) demyelinating neuropathy

chronic inflammatory demyelinating polyradiculopathy

hereditary sensory motor neuropathy (used to be called charcot marie tooth disease)

33

what is the presentation and duration of GBS like

progressive paraplegia over days lasts up to four weeks
peak symptoms at 10-14 days
associated sensory symptoms (pain very common) proceed weakness

34

what infection is associated with GBS

campylobacter
-inflammation of axon- stripped myelin

35

what is the prognosis of GBS

25% require ventilation
10% die form autonomic failure (cardiac arrythmia)

36

what is the treatment for GBS

immunoglobulin infusion and/ or plasma exchange

37

what is exam like in GBS

initially reflexes will be normal, as they ' go off legs' may loose them

38

what are the hereditary neuropathies

pure motor, sensory, sensorimotor, small fibre and autononmic variants
can be demyelinating or axonal
AD, AR, X linked types

39

what happens in the HMSN type 1 hereditary neuropathy

longstanding loss of muscle, pes cavus, thin distal musculature

40

what are the types of axonal neuropathies

idiopathic (age related)
vasculitis (mononeuritis multiplex)
paraneoplastic
infectious (HIV, syphillis, lyme, hepatitis)
drugs/ toxins
metabolic (diabetes, B12/ folate, hypothyroidism)

41

what are the causes of chronic autonomic neuropathy

diabetes (gastroparesis)
amyloidosis
hereditary

42

what are the acute causes of autonomic neuropathy

GBS
porphyria (unexplained abdo pain in the young)

43

what is the treatment for axonal peripheral neuropathy

treat cause e.g. infection
symptomatic relief (physio, orthotics, neuropathic pain relief)

if vasculitic
pulsed IV meythlprednisolone + cyclophosphamide

44

what is the treatment for demyelinating peripheral neurpathies

IV immunoglobulins
steroids
azathioprine, mycophenalate, cyclophosphamide