Common Peripheral Nervous System Disorders

Front 1

What are the clinical effects of demyelination

Back 1

Demyelination is often segmental.
• Sensory changes (e.g., paresthesias), often in a “glove and stocking” distribution

Front 2

What are the clinical effects of axonal degeneration of a peripheral nerve?

Back 2

Axonal degeneration
• Muscle fasciculations leading to muscle atrophy.

Front 3

inheritance pattern and prevalence of Charcot-Marie-Tooth (CMT) disease

Back 3

Most common hereditary neuropathy
• Autosomal dominant disease

Front 4

clinical findings of Charcot-Marie-Tooth (CMT) disease

Back 4

Peroneal nerve neuropathy
(1)Causes atrophy of muscles of lower legs
(2)Legs have an “inverted bottle” appearance

Front 5

CMT:

Back 5

lower legs have "inverted bottle" appearance

Front 6

definition of Guillain-Barré syndrome (GBS)

Back 6

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

Front 7

common preceding disorders of Guillain-Barré syndrome (GBS)

Back 7

Mycoplasma pneumoniae pneumonia, Campylobacter jejuni enteritis, EBV infection

Front 8

clinical and laboratory findings of Guillain-Barré syndrome (GBS)

Back 8

-Increased CSF protein but no cells
• Oligoclonal bands present on high resolution electrophoresis
- Majority recover with/without permanent disability
- Treatment is plasmapheresis.

Front 9

Guillain-Barré syndrome causes ___________________.

Back 9

ascending paralysis

Front 10

What is the mechanism for peripheral neuropathy in diabetes mellitus?

Back 10

Most common cause of peripheral neuropathy
-Due to osmotic damage of Schwann cells.

Front 11

Give examples of toxin-associated neuropathies.

Back 11

Alcohol, heavy metals, diphtheria

Front 12

cranial nerve involved

Back 12

-Inflammatory reaction of facial nerve (CN VII);

Front 13

associations

Back 13

May be associated with H. simplex (most common), HIV, sarcoidosis, Lyme disease
• Often bilateral in Lyme disease

Front 14

between lower motor neuron and upper motor neuron types with regards to clinical presentation (be able to recognize)

Back 14

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

Front 15

exact nerve tracts involved (know the schematic);

Back 15

Diagram comparing LMN and UMN Bell’s palsy

Front 16

innervation of levator palpebrae versus orbicularis oculi

Back 16

Inability to close the eye
(a) Orbicularis oculi innervated by CN VII
(b) Can open eye because levator palpebri is innervated by CN III

Front 17

LMN Bell’s palsy:

Back 17

H. simplex most common cause

Front 18

Idiopathic Bell’s palsy:

Back 18

facial muscle paralysis due to inflammation of CN VII

Front 19

examples of drugs that produce peripheral neuropathy

Back 19

Examples- vincristine, hydralazine

Front 20

examples of vitamin deficiencies that produce peripheral neuropathy

Back 20

Examples- deficiency of thiamine, vitamin B12, pyridoxine

Front 21

derivation of a schwannoma (neurilemoma)

Back 21

Benign tumor derived from Schwann cells

Front 22

most common cranial nerve involved and name of the tumor in a schwannoma (neurilemoma)

Back 22

Cranial nerves (CN) V (trigeminal) and VIII (acoustic)

Front 23

location of acoustic neuroma in a schwannoma (neurilemoma)

Back 23

Majority are located in the cerebellopontine angle
(1) Encapsulated tumors
(2) Microscopic shows alternating dark and light areas (Slide 56)

Front 24

microscopic appearance (be able to recognize) of a schwannoma (neurilemoma)

Back 24

Microscopic shows alternating dark and light areas (Slide 56)

Front 25

why schwannoma (neurilemoma) may have sensory changes

Back 25

Sensory changes in CN V distribution
• Due to tumor impingement on CN V

Front 26

associations of a schwannoma (neurilemoma)

Back 26

Associated with neurofibromatosis

Front 27

clinical presentation a schwannoma (neurilemoma)

Back 27

(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

Front 28

how a schwannoma (neurilemoma) differs from Meniere’s disease in terms of clinical presentation.

Back 28

Acoustic neuroma: tinnitus and sensorineural hearing loss

No vertigo. [ Vertigo (room spins around. Patient feels dizzy) ]