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Ataxia similar to cerebellar,but no nystagmus,dysarthria
Pattern of sensory loss Sensory loss of trunk,scalp,face d/t simultaneous damage of proximal&distal part of sensory nerve SENSORY GANGLIONOPATHY ESCUTCHEON pattern of sensory loss over abdomen and thorax SEVERE AXONAL NEUROPATHY Symmetrical,distal,legs>arms Can even progress to face POLY NEUROPATHY
NERVE FIBRE AFFECTED? Poor balance Diminished or absent reflexes tingling Decreased joint position sense Pin & needle sensation Decreased vibration sense numbness SIGNS SYMPTOMS LARGE FIBRE NEUROPATHY
SMALL FIBRE NEUROPATHY Diminished temperature sensation Tight band like pressure Insensitive to heat and cold Decreased pinprick sensation PAIN-burning,shock like,stabbing,prickling,shooting,lancinating Allodynia
Causes of small fibre neuropathy (painful NP&dissociated sensory loss)
Nl/dec normal absent dec/Nl DTR + absent Usually+ absent Sensoryloss absent Usually neg Can occur severe wasting absent absent Maybe+ve marked fasciculation Prox except SMA Extraoccular,bulbar distal distal Distribution of weakness ----- More in evening ------ ----- Fatigue,diurnalweakness variation Myopathy NMJ Neuropathy AHC