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Peripheral Nervous System Disorders

Terms in this set (73)

List the signs and symptoms of a peripheral nerve disorder.
numbness, paresthesias, pain, weakness, sensory loss, loss of muscle stretch reflexes, atrophy and fasciculations (if LMN)
Will you ever see increased muscle stretch reflexes with a peripheral nerve disorder?
No
Will you ever see increased muscle tone with a peripheral nerve disorder?
No
List the two possible patterns for peripheral nerve problems.
polyneuropathy, mononeuropathy
List the two patterns for a peripheral polyneuropathy.
distal, proximal and distal
What is the most common pattern of peripheral neuropathy?
distal
Describe the clinical picture of someone with a distal peripheral polyneuropathy.
sensory complaints start symmetrically in the feet and progress proximally, "glove and stocking" pattern, distal muscle weakness can occur, muscle stretch reflexes usually decreased especially after weakness develops
True or false: pathophysiologically, peripheral neuropathies may be due to damage to the axon or damage to the myelin covering the axon.
T
Overall, what is the most common cause of a distal peripheral polyneuropathy?
Diabetes Mellitis
List 11 other causes for distal peripheral polyneuropathy.
hereditary, chronic alcohol use, medications, thyroid disease, nutritional deficiencies (B1,6,12), renal failure, infections (HIV, Hep B/C, Lyme), paraneoplastic disorders, sarcoidosis, monoclonal gammopathies, unknown
What causes of peripheral polyneuropathy are demyelinating (the rest are degeneration of axon)?
hereditary, monoclonal gammopathies
What is the best screening test for peripheral neuropathy in someone with a high-risk disease for peripheral neuropathy?
monofilament testing plus vibration testing
Outline the evaluation for someone with a peripheral neuropathy.
1) Ask about Fh
2) HgbA1C, serum protein electrophoresis, Vitamin B12 with methylmalonic acid
3) TSH
4) HIV, Lymes, or LFTs (screen for hepatitis) based on risk factors
5) BUN/Cr, CBC, ESR (usually done)
Describe the clinical picture of someone with Charcot Marie Tooth Disease (HSMN) type IA.
slowly progressive symptoms which start in teenage/young adult but can occur in younger kids, weakness in feet, frequent sprained ankles, slow runners, atrophy in distal musculature, high arched feet, hammer toes, DECREASED reflexes, sensory loss, can progress to involve upper extremities
What is the most common form of hereditary neuropathy?
Charcot-Marie-Tooth Syndrome (Hereditary Sensory Motor Neuropathy Type 1A)
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