Peripheral Nerves disorders CCC
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| o Neuropathy | PNS disorder that results in disturbance or pathological changes
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| o Neuronopathy: | functional disturbance of the cell body
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| o Mononeuropathy: | affecting only one peripheral nerve
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| o Mononeuropathy multiplex: | affects multiple peripheral nerves in multiple limbs
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| o Polyneuropathy: | involves several contiguous peripheral nerves
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| o Sensorimotor: | involves sensory and motor portions of a nerve
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| o Neuropathic pain | pain from a damaged nerve that is either spontaneous or self-induced without a physiological purpose
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| o Allodynia: | pain sensation from a stimulus that is not normally painful
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| o Axonal neuropathy: | axon is the primary site of injury; results in abnormal NCV amplitudes with normal conduction velocity
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| o Demyelinating neuropathy: | myelin sheath is the primary site of injury; results in abnormal NCV conduction velocity with normal amplitude; may be segmental of diffuse
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| Where is sensory lost most common? | distal, symmetric, lower extremities
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| What is an electromyogram? | directly meausres electrical act. of skeletal muscles via a needle in the muscle belly to read act.
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| Guillain-Barre-describe | common, acute, autoimmune. Demyelination at peripheral nerve junction of ventral/dorsal roots. spreads along the nerve
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| Gullain-Barre tx | Tx: IVIg, plasmaphoresis; management of autonomic disturbances
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| Gullain-barre causative agent | C. jejuni; HIV-1
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| Clinical course of Gullain-Barre | Axonal degeneration. Rapidly progressive ascending symptoms: weakness in hands/feet up extremities areflexia increasing autonomic dysfunction and sensory loss respiratory compromise (requiring support)resolution. CSF: elevated protein; CBC normal
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| • Erb-Duchenne: | Plexiopathy due to traumatic separation of head and shoulder at birth or heavy backpacks; lesion at 5th/6th cervical roots or upper trunk
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| • Dejerine-Klumpke: | trauma, surgery, mass lesions; paresis in wrist/finger flexors and hand intrinsic muscles; sensory change in upper arm/forearm/ulnar aspect of hand; reduced triceps DTR, reduced finger flexion reflex; lesion in 8th cervical/1st thoracic root/medial cord
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| Other brachial plexopathys | post radiation, mass lessions, viral infections, vaccines.
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