Neuro - Peripheral Neuropathy

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peripheral neuropathy?

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develops as lesion to peripheral nervous system

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allodynia

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area of body becomes abnormally sensitive so distorted perception of touch - so pain experienced in response to stimulus that does not normally provoke pain

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sensory symptoms

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range from numbness to pricking, burning, or tingling sensations. allodynia. long term sensory neuropathy can lead to changes in skin, hair, bone, and joints

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chronic inflammatory demyelinating polyneuropathy

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damages sensory and motor nerves but leaves autonomic nerves intact

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guillain - barre syndrome

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rapid onset of weakness of limbs caused by acute inflammatory demyelinating neuropathy. triggered by an infection; can damage motor, sensory, and autonomic nerve fibers.

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paraneoplastic syndrome

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rare degenerative disorders triggered by immune responses to a tumor

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causes of peripheral neuropathy

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- injury or trauma, diseases, cancer, viruses, bacteria, exposure to toxins, medication toxicity, genetic mutations

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charcot-marie-tooth disorders

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most common form of inherited peripheral neuropathies. Hereditary motor and sensory neuropathy. Caused because there are mutations which cause defects in neuronal proteins and myelin sheath. Symptoms: extreme weakening and wasting of muscles in lower legs and feet; gait abnomalities; loss of tendon reflex; numbness in lower limbs - foot deformities common

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blood tests for peripheral neuropathy

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can detect diabetes, vitamin deficiencies, liver or kidney dysfunction, metabolic disorders, and signs of abnormal immune system activity

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nerve conduction velocity (NCV) tests

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measure degree of damage to large diameter nerve fibers - so can tell if symptoms are caused by degeneration of the myelin sheath or the axon. so electic stimulation is done and an electrode at the other end measures the speed of the impulse transmission along the axon

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electromyography (EMG)

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detect abnormal electrical activity in motor neuropathy = put needle into muscle and record electrical activity while the muscle is at rest and while the muscle is contracted

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magnetic resonance imaging (MRI)

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shows muscle quality and size, detect fatty replacement of muscle tissue, helps rule out tumors, herniated discs, or other abnormalities

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skin biopsy

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thin sample of skin is removed and examined for nerve fiber endings. This has advantages over NCV tests or nerve biopsy. less invasive than nerve biopsy and can reveal damage present in smaller fibers compared to NCV

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peripheral nerve regeneration?

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peripheral nerves can regenerate and can remyelinate axons if the nerve cell body isn't injured

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prednisone, cyclosporine, azathioprinecan

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immunosupressive drugs that can be used to reduce inflammation

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topically administered medications

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appropriate for localized chronic pain such as herpes zoster neuralgia (shingles). their usefulness for treating diffuse chronic diabetic neuropathy is more limited

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transcutaneous electrical nerve stimulation (TENS) therapy

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used for pain relief; electrodes are attached to skin at site of pain and low level electrical current is administered

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loss of protective sensation (LOPS)

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patients with neuropathy don't have important feedback that normally indicates injury. diabetic patients often buy shoes that are too small bc they can't feel the pressure of shoes on their feet