Thursday, 12 November 2009

peripheral neuropathy


clinicaly:

→Generalize wasting
→Normal tone
→Distal muscle weakness
→Absent ankles jerk with down going planters
→There is impaired sensation to light touch in stocking distribution
→There is impaired vibration and position sense up to the knees
→Describe the gate (sensory ataxia)
→No evidence of spinal surgery

Cause:
Motor, sensory or mixed.

Predominantly motor:
1-gullian Barre; acute/chronic
2-common peroneal nerve palsy
3-lead poisoning
4-porpheria

Predominantly sensory:
The most common cause is DM, other causes:
1-Alcohol
2-B12, B2 def
3-CRF
4-Drugs nitrofurantion/nincristine/cisplatin
5-leprosy
6-paraneoplastic
how would you investigate a patiet with peripheral neuropathy?

4 comments:

  1. investigations for peripheral neuropathy:
    fasting glucode
    serum vitamoin B12
    protein electrophresis
    FBC,ESR
    U&E,bone profile
    LFT & GGT
    CXR
    LP
    nerve biopsy
    nerve conduction study

    ReplyDelete
  2. nerve conduction study can differentiate between demyelinating and axonal peripheral neuropathy.

    demyelinating:prolong conduction velocities.
    axonal:reduce nerve action potential amplitude

    ReplyDelete
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