Polyneuropathy and Autonomic neuropathy Flashcards Preview

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Flashcards in Polyneuropathy and Autonomic neuropathy Deck (14):
1

 

 

What are metabolic causes of polyneuropathy?

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

2

 

 

What vitamin deficiencies can cause polyneuropathy?

 

  • B1, 6, 12
  • Nicotinic Acid
  • Drug related neuropathies

3

 

 

What types of neuropathy can occur in diabetes?

 

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

4

 

 

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

 

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

5

 

 

What are features of sensory neuropathy?

 

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

 

6

 

 

Are diabetic and alcoholic neuropathies painful?

 

 

Yes

7

 

 

What are features of motor neuropathy?

Often progressive

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

8

 

 

What are infectious causes of polyneuropathy?

 

  • Leprosy
  • HIV
  • Syphilis
  • Lyme disease

9

 

 

What are causes of autonomic neuropathy?

 

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

10

 

 

What are signs of sympathetic autonomic neuropathy?

 

  • Postural hypotension
  • Decreased sweating
  • Ejaculatory failure
  • Horner's syndrome

11

 

 

What are features of Parasympathetic autonomic neuropathy?

 

  • Constipation
  • Nocturnal diarrhoea
  • Urinary retention
  • Erectile dysfunction

12

 

 

How would you investigate someone for autonomic neuropathy?

 

  • BP
  • ECG
  • Cystometry
  • Pupils
  • Paraneoplastic antibodies

13

 

 

What spinal condition can occur asa  complication of B12 deficiency?

 

 

Subacute combined degeneration of the cord

14

 

 

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

Degeneration of  posterior and lateral columns of the spinal cord 

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