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28 Cards in this Set
- Front
- Back
What are the clinical effects of demyelination
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Demyelination is often segmental.
• Sensory changes (e.g., paresthesias), often in a “glove and stocking” distribution |
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What are the clinical effects of axonal degeneration of a peripheral nerve?
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Axonal degeneration
• Muscle fasciculations leading to muscle atrophy. |
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inheritance pattern and prevalence of Charcot-Marie-Tooth (CMT) disease
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Most common hereditary neuropathy
• Autosomal dominant disease |
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clinical findings of Charcot-Marie-Tooth (CMT) disease
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Peroneal nerve neuropathy
(1)Causes atrophy of muscles of lower legs (2)Legs have an “inverted bottle” appearance |
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CMT:
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lower legs have "inverted bottle" appearance
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definition of Guillain-Barré syndrome (GBS)
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Most common acute peripheral neuropathy
a. Autoimmune demyelination syndrome (1) peripheral and spinal nerves, and nerve fibers of ventral roots (2) Common preceding disorders (next card) b. Rapidly progressive ascending motor weakness (1) Less commonly descending motor weakness (2) Danger of respiratory muscle paralysis and death |
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common preceding disorders of Guillain-Barré syndrome (GBS)
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Mycoplasma pneumoniae pneumonia, Campylobacter jejuni enteritis, EBV infection
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clinical and laboratory findings of Guillain-Barré syndrome (GBS)
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-Increased CSF protein but no cells
• Oligoclonal bands present on high resolution electrophoresis - Majority recover with/without permanent disability - Treatment is plasmapheresis. |
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Guillain-Barré syndrome causes ___________________.
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ascending paralysis
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What is the mechanism for peripheral neuropathy in diabetes mellitus?
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Most common cause of peripheral neuropathy
-Due to osmotic damage of Schwann cells. |
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Give examples of toxin-associated neuropathies.
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Alcohol, heavy metals, diphtheria
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cranial nerve involved
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-Inflammatory reaction of facial nerve (CN VII);
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associations
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May be associated with H. simplex (most common), HIV, sarcoidosis, Lyme disease
• Often bilateral in Lyme disease |
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between lower motor neuron and upper motor neuron types with regards to clinical presentation (be able to recognize)
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Upper motor neuron (UMN) Bell’s palsy
(1) Contralateral lower face palsy (crossed corticobulbar pathway) (2) Sparing of upper face • Due to bilateral innervation from contralateral cortical centers |
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exact nerve tracts involved (know the schematic);
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Diagram comparing LMN and UMN Bell’s palsy
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innervation of levator palpebrae versus orbicularis oculi
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Inability to close the eye
(a) Orbicularis oculi innervated by CN VII (b) Can open eye because levator palpebri is innervated by CN III |
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LMN Bell’s palsy:
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H. simplex most common cause
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Idiopathic Bell’s palsy:
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facial muscle paralysis due to inflammation of CN VII
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examples of drugs that produce peripheral neuropathy
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Examples- vincristine, hydralazine
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examples of vitamin deficiencies that produce peripheral neuropathy
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Examples- deficiency of thiamine, vitamin B12, pyridoxine
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derivation of a schwannoma (neurilemoma)
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Benign tumor derived from Schwann cells
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most common cranial nerve involved and name of the tumor in a schwannoma (neurilemoma)
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Cranial nerves (CN) V (trigeminal) and VIII (acoustic)
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location of acoustic neuroma in a schwannoma (neurilemoma)
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Majority are located in the cerebellopontine angle
(1) Encapsulated tumors (2) Microscopic shows alternating dark and light areas (Slide 56) |
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microscopic appearance (be able to recognize) of a schwannoma (neurilemoma)
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Microscopic shows alternating dark and light areas (Slide 56)
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why schwannoma (neurilemoma) may have sensory changes
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Sensory changes in CN V distribution
• Due to tumor impingement on CN V |
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associations of a schwannoma (neurilemoma)
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Associated with neurofibromatosis
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clinical presentation a schwannoma (neurilemoma)
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(1) Associated with neurofibromatosis
• Unilateral or bilateral tumors (2) Tinnitus (ringing in the ears) (3) Sensorineural deafness (4) Sensory changes in CN V distribution • Due to tumor impingement on CN V |
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how a schwannoma (neurilemoma) differs from Meniere’s disease in terms of clinical presentation.
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Acoustic neuroma: tinnitus and sensorineural hearing loss
No vertigo. [ Vertigo (room spins around. Patient feels dizzy) ] |