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
→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?
investigations for peripheral neuropathy:
ReplyDeletefasting glucode
serum vitamoin B12
protein electrophresis
FBC,ESR
U&E,bone profile
LFT & GGT
CXR
LP
nerve biopsy
nerve conduction study
nerve conduction study can differentiate between demyelinating and axonal peripheral neuropathy.
ReplyDeletedemyelinating:prolong conduction velocities.
axonal:reduce nerve action potential amplitude
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