Lecture 3 Peripheral Neuropathy

Which part of the nervous system is involved in peripheral neuropathy?

What if UMN sign is present when patient is referred for peripheral neuropathy?

Peripheral neuropathy: clinical presentation from the motor perspective

Peripheral neuropathy: clinical presentation from the sensory perspective:

Peripheral neuropathy: clinical presentation from the autonomic perspective:

T/F: diabetic neuropathy typically starts with sensory disturbance and works its way from proximal to distal.

The easiest way to distinguish GBS from CIDP is by considering:

What are the 4 major categories of neurons?

Among all 4 types of degenerations, which ones causes more atrophy?

Define neuronal degeneration:

Define Wallerian degeneration:

Define segmental demyelination:

Define axonal degeneration

Steps of acute axonal insult at a specific point

T/F: basement membrane typically stays intact after wallerian degeneration.

Cause of mononeuropathy

Causes of polyneuropathy

What is the single most important diagnostic test for eval of neuropathy, which can determine whether it is primarily axonal, demyelinating or mixed.

What should be done to rule out GBS and CIDP?

Another name for Guillain-Barre

What mostly happens before GBS?

Is sensory affected in GBS?

Most common symptoms for GBS

What are some medical treatment for GBS?

More (male/female) are affected in GBS.

What are some variations of GBS?

T/F: GBS is autoimmune.

About ___% GBS has a preceding infection.

Which structure is affected in GBS?

For GBS, symptoms takes ______ to onset, it progresses rapidly for _____ to reach nadir and plateaus in about _________. In _______, some patient can recover fully.

Onset of GBS: symettrical or asymmetrical?

Can there be CN involvement in GBS?

Can there be autonomic dysfunciton in GBS?

What is the Golden standard diagnostic test for GBS?

Timeline for CSF protein level changes

What do you look for in blood tests of GBS patients?

What is a good test to do to rule out competing diagnoses in GBS patients?

Which tests can be done at the plateau stage of GBS?

What might happen if you perform EMG test right after diagnosis of GBS?

What can you expect in a patient's EMG, who has plateaued in GBS?

What do you expect to see in a GBS patient's NCV test?

What are some competing Dx of GBS?

What are the medical management options for GBS?

Does steroidal use help with GBS?

T/F: GBS cannot recover.

___% regain full strength in 1 year.

Does GBS re-occur?

Severe motor problems persist in ___ patients.

What are some negative prognostic factors?

After schwann cell recovery, there are (more/less) nodes along a single axon.

What is a result for collateral sprouting in early recovery?

Speed of axonal regrowth

T/F: GBS patients usually do not have pain.

What is a precaution during clinical management of GBS patients?

T/F: both GBS and CIDP are autoimmune diseases.

T/F: GBS and CIDP have the same mechanism of axonal degeneration.

How to differentiate CIDP from GBS?

Which of the following is a typical progression of CIDP?
A. stepwise progression with periods of plateau
B. Steadily declining course
C. Course with recurrent episodes

Which one has more sensory involvement, GBS or CIDP?

Signs and symptoms of CIDP:
1. Gradual progressive weakness over at least ________.
2. _____ reflex
3. flaccid muscle
4. (motor/sensory/autonomic) involvement
5. possible cranial and respiratory muscle weakness

What are some diagnostic studies in CIDP?

How will EMG be like in CIDP patients?

How does NCV look like in CIDP patients?

What are some competing diagnosis of CIDP?

Medical management options for CIDP

T/F: the relapse rate for CIDP is low.

Most common cause of neuropathy?

____% DM patients are likely going to develop polyneuropathy.

Typical presentation of DM-PN

How long does the progression of DM-PN take?

Onset of DM-PN: (sudden/ insidious)

Which one comes first in Dm-PN, sensory or motor loss?

What tests are needed to diagnos DM-PN?

What is special about EMG results in DM-PN patients?

What is the expected NCV results in patients with DM-PN?

What are some competing diagnoses of DM-PN?

What are the most important medical management for DM-PN patients?

Special sensory tests for DM-PN patients.