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Peripheral NervesCCC

Peripheral Nerves disorders CCC

o Neuropathy PNS disorder that results in disturbance or pathological changes
o Neuronopathy: functional disturbance of the cell body
o Mononeuropathy: affecting only one peripheral nerve
o Mononeuropathy multiplex: affects multiple peripheral nerves in multiple limbs
o Polyneuropathy: involves several contiguous peripheral nerves
o Sensorimotor: involves sensory and motor portions of a nerve
o Neuropathic pain pain from a damaged nerve that is either spontaneous or self-induced without a physiological purpose
o Allodynia: pain sensation from a stimulus that is not normally painful
o Axonal neuropathy: axon is the primary site of injury; results in abnormal NCV amplitudes with normal conduction velocity
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
Where is sensory lost most common? distal, symmetric, lower extremities
What is an electromyogram? directly meausres electrical act. of skeletal muscles via a needle in the muscle belly to read act.
 Guillain-Barre-describe common, acute, autoimmune. Demyelination at peripheral nerve junction of ventral/dorsal roots. spreads along the nerve
Gullain-Barre tx Tx: IVIg, plasmaphoresis; management of autonomic disturbances
Gullain-barre causative agent C. jejuni; HIV-1
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
• 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
• 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
Other brachial plexopathys post radiation, mass lessions, viral infections, vaccines.
Created by: VCOM2013