This document provides an overview of peripheral neuropathy. It begins by defining peripheral neuropathy as damage to the peripheral nervous system, which can affect motor, sensory and autonomic nerves. Symptoms depend on the affected nerves and include weakness, numbness, pain and organ dysfunction. Neuropathies can be acute or chronic, affect single or multiple nerves, and have many underlying causes including diabetes, toxins, medications and diseases. Evaluation involves history, exam, EMG/NCS to identify pattern of involvement, and testing tailored to suspected causes. Differential diagnosis and management are guided by clinical features and test results.
This document provides an overview of approaching peripheral nerve disease. It discusses taking a history and examining patients to identify signs that implicate peripheral nerve involvement. Electrodiagnostic studies are used to help diagnose and differentiate between neuropathies. Symptoms, signs, distribution patterns, temporal evolution, relevant history, examination findings, modalities of sensation loss, fiber involvement, autonomic symptoms, and other findings are described. Investigations including electrodiagnosis, nerve conduction studies, electromyography and findings that indicate axonal vs demyelinating neuropathies are also summarized.
This document defines and describes various types of peripheral neuropathy. It begins by defining peripheral neuropathy as disorders affecting the peripheral nervous system, which may involve sensory nerves, motor nerves, or both. Peripheral neuropathies can be categorized as mononeuropathy (affecting one nerve), polyneuropathy (affecting multiple nerves symmetrically), or mononeuropathy multiplex (affecting multiple nerves asymmetrically). The document then describes various specific types of peripheral neuropathies such as mononeuropathy, polyneuropathy, spinal nerve root disorders, plexopathy, and mononeuropathy multiplex. It outlines symptoms, distribution of weakness and sensory involvement, temporal evolution, and other diagnostic factors for peripheral neuropath
Neuromuscular Diseases medicine Seminar.pptxthekeyman1
Neuromuscular diseases involve injury or dysfunction of peripheral nerves or muscles. They can affect the cell bodies, axons, Schwann cells, or neuromuscular junction. The main categories of neuromuscular diseases are peripheral nerve disorders, motor neuron disease, neuromuscular junction disease, and muscle disease. Peripheral neuropathies can be classified as polyneuropathies or mononeuropathies. Common polyneuropathies include diabetic neuropathy, Guillain-Barré syndrome, and chronic inflammatory demyelinating polyneuropathy. Motor neuron diseases primarily include amyotrophic lateral sclerosis. Myasthenia gravis is the most common neuromuscular junction disease. Muscular dyst
Approach to a patient with peripheral neuropathyTikal Kansara
This document provides an overview of approaching a patient with peripheral neuropathy. It discusses:
- The global burden of peripheral neuropathy, with diabetes being a leading cause.
- The basic anatomy of peripheral nerves and pathogenic mechanisms of nerve damage, including segmental degeneration, Wallerian degeneration, and axonal degeneration.
- Key questions to ask patients regarding the systems involved, duration and nature of symptoms, evidence of upper motor involvement, temporal evolution, potential hereditary causes, and other medical conditions.
- Types of neuropathy classified by pattern of involvement, clinical course, and other factors to help differentiate diagnoses.
This document discusses peripheral neuropathy, including:
1. It defines peripheral neuropathy and describes the different types that can affect motor, sensory, or autonomic nerves.
2. It outlines various causes of peripheral neuropathies including hereditary, infectious, inflammatory, metabolic, toxic, and more.
3. It describes the clinical presentations of different types of peripheral neuropathies based on the affected nerves and provides examples.
Peripheral neuropathies can be classified into several types based on the pattern of nerve involvement:
1) Mononeuropathy affects a single nerve and can be caused by direct injury, ischemia, or inflammation. Carpal tunnel syndrome is an example.
2) Mononeuritis multiplex involves multiple individual nerves developing lesions over time and is often seen in vasculitis.
3) Polyneuropathy damages many nerve cells across the body symmetrically and can be caused by systemic processes like diabetes or toxins.
Neuropathies are caused by a wide range of factors including metabolic diseases, infections, nutritional deficiencies, autoimmune disease, drugs, and toxins. Identifying the pattern of nerve
Peripheral neuropathy is damage to the peripheral nervous system, affecting nerves outside of the brain and spinal cord. It can be caused by diseases of the nerves themselves or systemic illness. There are several types including mononeuropathy (affecting a single nerve), mononeuritis multiplex (affecting multiple individual nerves), and polyneuropathy (affecting many nerves symmetrically). Common causes include diabetes, alcohol use, toxins, genetics, and metabolic conditions. Symptoms vary depending on the type and nerves involved but may include pain, numbness, tingling, muscle weakness and loss of sensation. Diagnosis involves clinical exams, nerve conduction tests, and identifying underlying causes. Treatment focuses on managing the cause, treating pain symptoms
This document provides an overview of approaching peripheral nerve disease. It discusses taking a history and examining patients to identify signs that implicate peripheral nerve involvement. Electrodiagnostic studies are used to help diagnose and differentiate between neuropathies. Symptoms, signs, distribution patterns, temporal evolution, relevant history, examination findings, modalities of sensation loss, fiber involvement, autonomic symptoms, and other findings are described. Investigations including electrodiagnosis, nerve conduction studies, electromyography and findings that indicate axonal vs demyelinating neuropathies are also summarized.
This document defines and describes various types of peripheral neuropathy. It begins by defining peripheral neuropathy as disorders affecting the peripheral nervous system, which may involve sensory nerves, motor nerves, or both. Peripheral neuropathies can be categorized as mononeuropathy (affecting one nerve), polyneuropathy (affecting multiple nerves symmetrically), or mononeuropathy multiplex (affecting multiple nerves asymmetrically). The document then describes various specific types of peripheral neuropathies such as mononeuropathy, polyneuropathy, spinal nerve root disorders, plexopathy, and mononeuropathy multiplex. It outlines symptoms, distribution of weakness and sensory involvement, temporal evolution, and other diagnostic factors for peripheral neuropath
Neuromuscular Diseases medicine Seminar.pptxthekeyman1
Neuromuscular diseases involve injury or dysfunction of peripheral nerves or muscles. They can affect the cell bodies, axons, Schwann cells, or neuromuscular junction. The main categories of neuromuscular diseases are peripheral nerve disorders, motor neuron disease, neuromuscular junction disease, and muscle disease. Peripheral neuropathies can be classified as polyneuropathies or mononeuropathies. Common polyneuropathies include diabetic neuropathy, Guillain-Barré syndrome, and chronic inflammatory demyelinating polyneuropathy. Motor neuron diseases primarily include amyotrophic lateral sclerosis. Myasthenia gravis is the most common neuromuscular junction disease. Muscular dyst
Approach to a patient with peripheral neuropathyTikal Kansara
This document provides an overview of approaching a patient with peripheral neuropathy. It discusses:
- The global burden of peripheral neuropathy, with diabetes being a leading cause.
- The basic anatomy of peripheral nerves and pathogenic mechanisms of nerve damage, including segmental degeneration, Wallerian degeneration, and axonal degeneration.
- Key questions to ask patients regarding the systems involved, duration and nature of symptoms, evidence of upper motor involvement, temporal evolution, potential hereditary causes, and other medical conditions.
- Types of neuropathy classified by pattern of involvement, clinical course, and other factors to help differentiate diagnoses.
This document discusses peripheral neuropathy, including:
1. It defines peripheral neuropathy and describes the different types that can affect motor, sensory, or autonomic nerves.
2. It outlines various causes of peripheral neuropathies including hereditary, infectious, inflammatory, metabolic, toxic, and more.
3. It describes the clinical presentations of different types of peripheral neuropathies based on the affected nerves and provides examples.
Peripheral neuropathies can be classified into several types based on the pattern of nerve involvement:
1) Mononeuropathy affects a single nerve and can be caused by direct injury, ischemia, or inflammation. Carpal tunnel syndrome is an example.
2) Mononeuritis multiplex involves multiple individual nerves developing lesions over time and is often seen in vasculitis.
3) Polyneuropathy damages many nerve cells across the body symmetrically and can be caused by systemic processes like diabetes or toxins.
Neuropathies are caused by a wide range of factors including metabolic diseases, infections, nutritional deficiencies, autoimmune disease, drugs, and toxins. Identifying the pattern of nerve
Peripheral neuropathy is damage to the peripheral nervous system, affecting nerves outside of the brain and spinal cord. It can be caused by diseases of the nerves themselves or systemic illness. There are several types including mononeuropathy (affecting a single nerve), mononeuritis multiplex (affecting multiple individual nerves), and polyneuropathy (affecting many nerves symmetrically). Common causes include diabetes, alcohol use, toxins, genetics, and metabolic conditions. Symptoms vary depending on the type and nerves involved but may include pain, numbness, tingling, muscle weakness and loss of sensation. Diagnosis involves clinical exams, nerve conduction tests, and identifying underlying causes. Treatment focuses on managing the cause, treating pain symptoms
This document discusses peripheral neuropathy, including:
- The clinical effects of motor, sensory, and autonomic nerve injury, including weakness, loss of sensation, and autonomic dysfunction.
- The two main types of peripheral neuropathies - axonopathies which affect nerve fibers, and myelinopathies which affect the myelin sheath.
- The many potential causes of peripheral neuropathy both inherited and acquired, such as diabetes, toxins, infections, inflammation and genetic disorders. A thorough history and examination is needed to determine the underlying cause.
This document discusses peripheral neuropathy, including:
1. Peripheral neuropathy is inflammation and degeneration of the peripheral nerves or cranial nerves, impairing their conductivity. Common causes include diseases like diabetes, medications, trauma, toxins, and genetic factors.
2. Peripheral neuropathies can be classified based on the type of nerve affected (motor, sensory, autonomic), number of nerves (mononeuropathy, mononeuritis multiplex, polyneuropathy), or the pathological process (inflammation, compression, toxicity).
3. Clinical examination helps classify the neuropathy based on features like distribution of symptoms, timing, associated findings, and results of electrodiagnosis and lab tests
This document provides an overview of peripheral neuropathy including:
1. It describes a typical case of diabetic peripheral neuropathy presenting with leg weakness, numb feet, and pain.
2. It asks questions to help classify the neuropathy including type of nerve fibers involved and diagnostic approach.
3. It outlines the lesson which will define neuropathy, discuss anatomy/physiology, classification, clinical features, investigations and management.
This document provides an overview of peripheral neuropathy, including:
- Types of peripheral neuropathy are classified based on whether they primarily affect motor nerves, sensory nerves, or both.
- The main symptoms of motor, sensory, and autonomic neuropathies are described.
- The most common causes of peripheral neuropathy include systemic disorders like diabetes, connective tissue diseases, nutritional deficiencies, infections, malignancies and toxic neuropathies.
- The approach to evaluating a patient with peripheral neuropathy involves obtaining a history, neurological exam, electrodiagnostic studies and sometimes nerve biopsy to identify the location and cause of the neuropathy.
Peripheral neuropathy can affect motor, sensory, and autonomic nerves. It can be caused by damage to myelin sheaths, axons, or nerve sections from issues like diabetes, toxins, compression, or inflammation. Symptoms depend on the type and location of nerves affected and may include weakness, sensory loss, reflex changes, and autonomic dysfunction. Diagnosis involves assessing the pattern, timing, and distribution of symptoms along with electrodiagnostic testing and lab work to identify underlying causes and guide treatment. Treatment aims to address underlying causes and manage symptoms like pain.
Central Nervous System, Epilepsy, Parkinson, Alzheimer, Stroke and Migraine.Dr. Kiran Dhamak
Central Nervous System is one of the unit in Pharmacotherapeutics Subject which is for Second Year Diploma in Pharmacy. The unit covers diseases like Epilepsy, Parkinson, Alzheimer, Stroke and Migraine. The presentation includes the point as per diploma in pharmacy students may understand very easily. The syllabus is framed by Pharmacy Council of India which is implemented by MSBTE ER 2020-2021
This document provides an overview of topics in neurological examination, including:
1. The neurological exam involves assessing history, mental status, cranial nerves, motor function, sensory function, and coordination.
2. In the exam, stance and gait are evaluated by having the patient stand with feet together and closed eyes (Romberg's test) and timing their walk over 10 meters.
3. Common neurological conditions are assessed through history questions about symptoms like weakness, sensory changes, and abnormal movements. Transient loss of consciousness requires asking about warning symptoms and movements during and after the episode.
This document provides an overview of nervous system physiology, diseases treated by pregabalin, and key topics in neurobiology. It discusses the central and peripheral nervous systems, neurons, neurotransmitters, voltage-gated calcium channels, and conditions such as diabetic peripheral neuropathy, post-herpetic neuralgia, fibromyalgia, and partial onset seizures. The goal is to explain the nervous system, diseases treated by pregabalin, and provide neurobiological context.
This ppt describes various movement disorders found commonly in elderly persons. It also describes hyper and hypokinetic disorder categorization with cause and pathophysiology of movement disorders.
- Neuropathy is damage or dysfunction of nerves that causes numbness, tingling, weakness and pain. It can be cranial neuropathy affecting the brain/brainstem or peripheral neuropathy outside the brain/spinal cord.
- Cranial neuropathy types include Bell's palsy, microvascular issues affecting vision nerves, and damage to nerves controlling eye movement. Peripheral neuropathy can be motor, sensory or autonomic.
- Neuropathy is caused by infections, cancer, increased pressure, vascular issues like diabetes, autoimmune disorders, medications, and vitamin deficiencies. Symptoms vary but include pain, sensory changes, and weakness. Diagnosis involves exams, tests and sometimes biopsies. Treatment focuses on pain management, physical
SilverStreak hospital is located in the New Gurgaon area. Thanks to Dr. V K Gupta, the institutor of the hospital. Silver Streak Hospital has become over the course of the years with considerable expansion in bed strength, foundation and a confirmation of value patient consideration with human touch utilizing best in class innovation with quality medical services under one rooftop. We are known as the best Neurology Hospital in New Gurgaon with Top Neurology Doctors and furthermore has surprisingly as the principal Neuro Hospital in New Gurgaon to got the desired ISO-9002 confirmation grant which has been recently upgraded to ISO 9001:2008.
1362405401 painful neuropathy syndrome, new treatments akdskkdfsimedia
This document discusses diabetic painful neuropathy, which requires attention due to its painful condition and wide spectrum of clinical syndromes. It describes various types of diabetic neuropathy including symmetrical distal polyneuropathies affecting small or large fibers, proximal motor neuropathies, and focal asymmetric neuropathies affecting specific areas. Symptoms, clinical features, and treatment approaches are outlined for each type. A variety of drugs are discussed for treating painful diabetic neuropathy, including nonsteroidal anti-inflammatories, anticonvulsants, antidepressants, and capsaicin cream.
1362576547 painful neuropathy syndrome, new treatments akdskkdfsimedia
This document discusses diabetic painful neuropathy, which requires attention due to its painful condition and wide spectrum of clinical syndromes. It describes various types of diabetic neuropathy including symmetrical distal polyneuropathies affecting small and large fibers, proximal motor neuropathies, and focal asymmetric neuropathies affecting specific areas. Symptoms, clinical features, and treatments for different types are outlined. Relief of pain is important, though current treatment options provide unsatisfactory relief and consist of analgesics, antidepressants, anticonvulsants, and capsaicin cream.
This document provides an overview of peripheral neuropathies. It defines different types including polyneuropathy, mononeuropathy, and neuropathy. It describes approaches to identifying the lesion location and cause. Common causes discussed include diabetes, uraemia, thyroid disease, porphyria, alcohol, and various vitamin deficiencies. Guillain-Barré syndrome is described as the most common acute polyneuropathy, caused by preceding infection. Management of GBS involves monitoring respiratory function and treatments like immunoglobulin or plasma exchange.
This document discusses peripheral neuropathy, which refers to diseases that affect nerves outside the brain and spinal cord. It covers the types of peripheral nerves and classifications of neuropathies. Some key causes of peripheral neuropathy discussed include diabetes, nutritional deficiencies like B1/B12 deficiency, alcoholism, infections like HIV and leprosy, and certain drugs. Symptoms, clinical presentations, investigations, and treatment approaches for different types of peripheral neuropathies are also summarized.
This document provides guidance on taking a thorough neurologic history. It outlines key areas to cover including chief complaint, history of present illness, past medical history, family history, social history, and review of systems. Collecting information on location, time course, exacerbating/relieving factors, and associated symptoms is important. Relevant histories include illnesses, operations, medications, diet, substance use and more. The goal is to obtain a clear understanding of the issue to guide further exam and work towards a diagnosis.
This document provides an overview of disorders of the motor unit, including motor neuron disease, peripheral nerve disorders, neuromuscular junction disease, and muscle disease. It summarizes key details about amyotrophic lateral sclerosis (ALS), including symptoms, progression, mortality rates, and current theories about etiology. Polyneuropathies are described in terms of symptoms, signs, classification (e.g. by fiber type or pathology), and evaluation approach. Specific conditions like Guillain-Barré syndrome, myasthenia gravis, and Duchenne muscular dystrophy are also summarized.
Guillain-Barré syndrome (GBS) can be described as a collection of clinical syndromes that manifests as an acute inflammatory polyradiculoneuropathy with resultant weakness and diminished reflexes.
Although the classic description of GBS is that of a demyelinating neuropathy with ascending weakness, many clinical variants have been well documented in the medical literature.
The document discusses various causes of dizziness including vertigo, presyncope, disequilibrium, and non-specific dizziness. Vertigo is characterized by illusions of motion and is commonly caused by peripheral vestibular disorders. Positional vertigo can be distinguished from presyncope by provoking dizziness with changes in head position rather than lowering blood pressure. Disequilibrium causes an unsteady feeling when walking and may result from neurological or musculoskeletal disorders. Non-specific dizziness is difficult for patients to describe and has a broad differential diagnosis. Evaluation of dizziness involves distinguishing these subtypes and identifying potential causes based on associated symptoms, physical exam findings, and test results.
The document summarizes apoptosis and necrosis. Apoptosis is programmed cell death where cells shrink and are engulfed by other cells without inflammation. Necrosis is unprogrammed cell death where cells swell and lyse, releasing toxic contents and causing inflammation. The stages and functions of apoptosis are described, including its roles in development, immunity, and disease when there is too much or too little. Different forms of necrosis like coagulative, liquefactive, and caseous necrosis are also outlined.
Hashimoto's thyroiditis is an autoimmune disease characterized by lymphocytic infiltration of the thyroid gland, diffuse goiter, and the presence of thyroid autoantibodies. It is the most common cause of hypothyroidism in iodine-sufficient areas. The disease has a genetic basis and is more common in females between ages 30-50. Pathologically, it presents as diffuse symmetric thyroid enlargement with extensive lymphocytic infiltration and follicular destruction, resulting in decreased thyroid function.
This document discusses peripheral neuropathy, including:
- The clinical effects of motor, sensory, and autonomic nerve injury, including weakness, loss of sensation, and autonomic dysfunction.
- The two main types of peripheral neuropathies - axonopathies which affect nerve fibers, and myelinopathies which affect the myelin sheath.
- The many potential causes of peripheral neuropathy both inherited and acquired, such as diabetes, toxins, infections, inflammation and genetic disorders. A thorough history and examination is needed to determine the underlying cause.
This document discusses peripheral neuropathy, including:
1. Peripheral neuropathy is inflammation and degeneration of the peripheral nerves or cranial nerves, impairing their conductivity. Common causes include diseases like diabetes, medications, trauma, toxins, and genetic factors.
2. Peripheral neuropathies can be classified based on the type of nerve affected (motor, sensory, autonomic), number of nerves (mononeuropathy, mononeuritis multiplex, polyneuropathy), or the pathological process (inflammation, compression, toxicity).
3. Clinical examination helps classify the neuropathy based on features like distribution of symptoms, timing, associated findings, and results of electrodiagnosis and lab tests
This document provides an overview of peripheral neuropathy including:
1. It describes a typical case of diabetic peripheral neuropathy presenting with leg weakness, numb feet, and pain.
2. It asks questions to help classify the neuropathy including type of nerve fibers involved and diagnostic approach.
3. It outlines the lesson which will define neuropathy, discuss anatomy/physiology, classification, clinical features, investigations and management.
This document provides an overview of peripheral neuropathy, including:
- Types of peripheral neuropathy are classified based on whether they primarily affect motor nerves, sensory nerves, or both.
- The main symptoms of motor, sensory, and autonomic neuropathies are described.
- The most common causes of peripheral neuropathy include systemic disorders like diabetes, connective tissue diseases, nutritional deficiencies, infections, malignancies and toxic neuropathies.
- The approach to evaluating a patient with peripheral neuropathy involves obtaining a history, neurological exam, electrodiagnostic studies and sometimes nerve biopsy to identify the location and cause of the neuropathy.
Peripheral neuropathy can affect motor, sensory, and autonomic nerves. It can be caused by damage to myelin sheaths, axons, or nerve sections from issues like diabetes, toxins, compression, or inflammation. Symptoms depend on the type and location of nerves affected and may include weakness, sensory loss, reflex changes, and autonomic dysfunction. Diagnosis involves assessing the pattern, timing, and distribution of symptoms along with electrodiagnostic testing and lab work to identify underlying causes and guide treatment. Treatment aims to address underlying causes and manage symptoms like pain.
Central Nervous System, Epilepsy, Parkinson, Alzheimer, Stroke and Migraine.Dr. Kiran Dhamak
Central Nervous System is one of the unit in Pharmacotherapeutics Subject which is for Second Year Diploma in Pharmacy. The unit covers diseases like Epilepsy, Parkinson, Alzheimer, Stroke and Migraine. The presentation includes the point as per diploma in pharmacy students may understand very easily. The syllabus is framed by Pharmacy Council of India which is implemented by MSBTE ER 2020-2021
This document provides an overview of topics in neurological examination, including:
1. The neurological exam involves assessing history, mental status, cranial nerves, motor function, sensory function, and coordination.
2. In the exam, stance and gait are evaluated by having the patient stand with feet together and closed eyes (Romberg's test) and timing their walk over 10 meters.
3. Common neurological conditions are assessed through history questions about symptoms like weakness, sensory changes, and abnormal movements. Transient loss of consciousness requires asking about warning symptoms and movements during and after the episode.
This document provides an overview of nervous system physiology, diseases treated by pregabalin, and key topics in neurobiology. It discusses the central and peripheral nervous systems, neurons, neurotransmitters, voltage-gated calcium channels, and conditions such as diabetic peripheral neuropathy, post-herpetic neuralgia, fibromyalgia, and partial onset seizures. The goal is to explain the nervous system, diseases treated by pregabalin, and provide neurobiological context.
This ppt describes various movement disorders found commonly in elderly persons. It also describes hyper and hypokinetic disorder categorization with cause and pathophysiology of movement disorders.
- Neuropathy is damage or dysfunction of nerves that causes numbness, tingling, weakness and pain. It can be cranial neuropathy affecting the brain/brainstem or peripheral neuropathy outside the brain/spinal cord.
- Cranial neuropathy types include Bell's palsy, microvascular issues affecting vision nerves, and damage to nerves controlling eye movement. Peripheral neuropathy can be motor, sensory or autonomic.
- Neuropathy is caused by infections, cancer, increased pressure, vascular issues like diabetes, autoimmune disorders, medications, and vitamin deficiencies. Symptoms vary but include pain, sensory changes, and weakness. Diagnosis involves exams, tests and sometimes biopsies. Treatment focuses on pain management, physical
SilverStreak hospital is located in the New Gurgaon area. Thanks to Dr. V K Gupta, the institutor of the hospital. Silver Streak Hospital has become over the course of the years with considerable expansion in bed strength, foundation and a confirmation of value patient consideration with human touch utilizing best in class innovation with quality medical services under one rooftop. We are known as the best Neurology Hospital in New Gurgaon with Top Neurology Doctors and furthermore has surprisingly as the principal Neuro Hospital in New Gurgaon to got the desired ISO-9002 confirmation grant which has been recently upgraded to ISO 9001:2008.
1362405401 painful neuropathy syndrome, new treatments akdskkdfsimedia
This document discusses diabetic painful neuropathy, which requires attention due to its painful condition and wide spectrum of clinical syndromes. It describes various types of diabetic neuropathy including symmetrical distal polyneuropathies affecting small or large fibers, proximal motor neuropathies, and focal asymmetric neuropathies affecting specific areas. Symptoms, clinical features, and treatment approaches are outlined for each type. A variety of drugs are discussed for treating painful diabetic neuropathy, including nonsteroidal anti-inflammatories, anticonvulsants, antidepressants, and capsaicin cream.
1362576547 painful neuropathy syndrome, new treatments akdskkdfsimedia
This document discusses diabetic painful neuropathy, which requires attention due to its painful condition and wide spectrum of clinical syndromes. It describes various types of diabetic neuropathy including symmetrical distal polyneuropathies affecting small and large fibers, proximal motor neuropathies, and focal asymmetric neuropathies affecting specific areas. Symptoms, clinical features, and treatments for different types are outlined. Relief of pain is important, though current treatment options provide unsatisfactory relief and consist of analgesics, antidepressants, anticonvulsants, and capsaicin cream.
This document provides an overview of peripheral neuropathies. It defines different types including polyneuropathy, mononeuropathy, and neuropathy. It describes approaches to identifying the lesion location and cause. Common causes discussed include diabetes, uraemia, thyroid disease, porphyria, alcohol, and various vitamin deficiencies. Guillain-Barré syndrome is described as the most common acute polyneuropathy, caused by preceding infection. Management of GBS involves monitoring respiratory function and treatments like immunoglobulin or plasma exchange.
This document discusses peripheral neuropathy, which refers to diseases that affect nerves outside the brain and spinal cord. It covers the types of peripheral nerves and classifications of neuropathies. Some key causes of peripheral neuropathy discussed include diabetes, nutritional deficiencies like B1/B12 deficiency, alcoholism, infections like HIV and leprosy, and certain drugs. Symptoms, clinical presentations, investigations, and treatment approaches for different types of peripheral neuropathies are also summarized.
This document provides guidance on taking a thorough neurologic history. It outlines key areas to cover including chief complaint, history of present illness, past medical history, family history, social history, and review of systems. Collecting information on location, time course, exacerbating/relieving factors, and associated symptoms is important. Relevant histories include illnesses, operations, medications, diet, substance use and more. The goal is to obtain a clear understanding of the issue to guide further exam and work towards a diagnosis.
This document provides an overview of disorders of the motor unit, including motor neuron disease, peripheral nerve disorders, neuromuscular junction disease, and muscle disease. It summarizes key details about amyotrophic lateral sclerosis (ALS), including symptoms, progression, mortality rates, and current theories about etiology. Polyneuropathies are described in terms of symptoms, signs, classification (e.g. by fiber type or pathology), and evaluation approach. Specific conditions like Guillain-Barré syndrome, myasthenia gravis, and Duchenne muscular dystrophy are also summarized.
Guillain-Barré syndrome (GBS) can be described as a collection of clinical syndromes that manifests as an acute inflammatory polyradiculoneuropathy with resultant weakness and diminished reflexes.
Although the classic description of GBS is that of a demyelinating neuropathy with ascending weakness, many clinical variants have been well documented in the medical literature.
The document discusses various causes of dizziness including vertigo, presyncope, disequilibrium, and non-specific dizziness. Vertigo is characterized by illusions of motion and is commonly caused by peripheral vestibular disorders. Positional vertigo can be distinguished from presyncope by provoking dizziness with changes in head position rather than lowering blood pressure. Disequilibrium causes an unsteady feeling when walking and may result from neurological or musculoskeletal disorders. Non-specific dizziness is difficult for patients to describe and has a broad differential diagnosis. Evaluation of dizziness involves distinguishing these subtypes and identifying potential causes based on associated symptoms, physical exam findings, and test results.
The document summarizes apoptosis and necrosis. Apoptosis is programmed cell death where cells shrink and are engulfed by other cells without inflammation. Necrosis is unprogrammed cell death where cells swell and lyse, releasing toxic contents and causing inflammation. The stages and functions of apoptosis are described, including its roles in development, immunity, and disease when there is too much or too little. Different forms of necrosis like coagulative, liquefactive, and caseous necrosis are also outlined.
Hashimoto's thyroiditis is an autoimmune disease characterized by lymphocytic infiltration of the thyroid gland, diffuse goiter, and the presence of thyroid autoantibodies. It is the most common cause of hypothyroidism in iodine-sufficient areas. The disease has a genetic basis and is more common in females between ages 30-50. Pathologically, it presents as diffuse symmetric thyroid enlargement with extensive lymphocytic infiltration and follicular destruction, resulting in decreased thyroid function.
Most primary thyroid tumors originate from follicular epithelial cells or parafollicular C-cells. The most common benign thyroid tumor is a follicular adenoma, which presents as a solitary nodule found in about 1% of the population. Follicular adenoma occurs more frequently in adult women and can be distinguished from thyroid carcinoma or nodular goiter by its encapsulation, distinct architecture inside and outside the capsule, and compression of surrounding thyroid tissue. Histologically, follicular adenoma shows complete fibrous encapsulation and benign follicular epithelial cells lining follicles of various sizes that may form trabecular, solid or cord patterns with little follicle formation. There are six recognized growth patterns of follicular adenoma.
1. Free radicals are molecules with unpaired electrons that can damage cells. They are produced through normal metabolism but also environmental exposures like pollution.
2. The body has antioxidant defenses like SOD and glutathione peroxidase to neutralize free radicals, but an excess can lead to oxidative stress implicated in conditions like inflammation and aging.
3. Dietary antioxidants from fruits and vegetables can help reduce oxidative damage by free radicals in cells and tissues.
This document discusses meningitis, including its causes, symptoms, diagnosis, and treatment. Meningitis is an inflammation of the meninges caused by bacteria, viruses, or fungi. It occurs when pathogens invade the bloodstream and cross the blood-brain barrier. Common symptoms include fever, headache, stiff neck, and vomiting. Diagnosis involves lumbar puncture and examination of cerebrospinal fluid. Treatment focuses on antibiotics and managing complications such as shock. Prompt treatment is important as meningitis can cause long-term issues like hearing loss and developmental delays if not addressed quickly.
1. Osteomyelitis is an infection of bone that can be caused by various systemic infectious diseases spreading to the bone or directly through injuries or surgery.
2. Pyogenic osteomyelitis is usually caused by bacterial infection, most commonly Staphylococcus aureus, and presents differently in developing versus developed countries.
3. Tuberculous osteomyelitis is caused by Mycobacterium tuberculosis spreading hematogenously from sites like the lungs and can lead to caseous necrosis and bone destruction if left untreated.
Chronic bronchitis is defined as a persistent cough with mucus production for at least three months a year for two consecutive years. The two most important causes are cigarette smoking and air pollution. Smoking impairs ciliary function and mucus clearance, stimulates mucus gland hypertrophy, and causes airway obstruction. Air pollution from sources like sulfur dioxide and particulate matter also increases the risk. Occupational exposures and infections can contribute as well. On a microscopic level, chronic bronchitis is defined by increased thickness of the mucus glands in the airways. Clinically, patients experience persistent cough and sputum production along with recurrent respiratory infections and exertional dyspnea.
Osteoarthritis is the most common form of chronic joint disorder characterized by progressive degeneration of articular cartilage over years, especially in weight-bearing joints. It occurs primarily as age-related wear and tear or secondarily from previous joint injuries or inflammation. In advanced cases, it leads to cartilage loss, bone changes like osteophyte formation, and mild synovitis. Suppurative arthritis is an acute infectious joint inflammation most often caused by bacteria reaching the joint from blood or direct contamination. It results in synovial swelling, effusion, and sometimes fibrosis or ankylosis. Gout is caused by hyperuricemia and deposition of urate crystals in joints and tissues, leading to acute inflammatory attacks or
This document discusses vertigo and disorders of equilibrium. It begins by defining equilibrium and its neural pathways. Vertigo is defined as an illusion of movement and is distinguished from non-vertiginous dizziness. A history, physical exam, and testing can help localize the cause as either peripheral or central. Peripheral causes like benign positional vertigo typically produce intermittent vertigo and nystagmus in one direction, while central causes may involve neurologic signs and multidirectional nystagmus. Specific peripheral disorders discussed in detail include benign positional vertigo and Meniere's disease.
This document summarizes a study on complementary and alternative medicine (CAM) use among Myasthenia gravis patients in Germany. The study found that over 30% of surveyed patients used CAM, with women and those suffering longer more likely to use CAM. CAM users reported more symptoms and disabilities as well as lower quality of life scores. The findings suggest CAM use may be related to efforts to improve quality of life for patients with more severe presentations of Myasthenia gravis.
Psoriasis is a chronic skin condition affecting about 2% of the population. It typically appears between ages 15-30 as red, scaly patches on the scalp, back, knees, and elbows. In about 5% of cases it can cause psoriatic arthritis. Histologically, psoriatic lesions show thickened epidermis with parakeratosis and saw-toothed rete ridges, basal layer degeneration, and a band of mononuclear cells in the dermis.
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
The simplified electron and muon model, Oscillating Spacetime: The Foundation...RitikBhardwaj56
Discover the Simplified Electron and Muon Model: A New Wave-Based Approach to Understanding Particles delves into a groundbreaking theory that presents electrons and muons as rotating soliton waves within oscillating spacetime. Geared towards students, researchers, and science buffs, this book breaks down complex ideas into simple explanations. It covers topics such as electron waves, temporal dynamics, and the implications of this model on particle physics. With clear illustrations and easy-to-follow explanations, readers will gain a new outlook on the universe's fundamental nature.
How to Make a Field Mandatory in Odoo 17Celine George
In Odoo, making a field required can be done through both Python code and XML views. When you set the required attribute to True in Python code, it makes the field required across all views where it's used. Conversely, when you set the required attribute in XML views, it makes the field required only in the context of that particular view.
How to Manage Your Lost Opportunities in Odoo 17 CRMCeline George
Odoo 17 CRM allows us to track why we lose sales opportunities with "Lost Reasons." This helps analyze our sales process and identify areas for improvement. Here's how to configure lost reasons in Odoo 17 CRM
A review of the growth of the Israel Genealogy Research Association Database Collection for the last 12 months. Our collection is now passed the 3 million mark and still growing. See which archives have contributed the most. See the different types of records we have, and which years have had records added. You can also see what we have for the future.
বাংলাদেশের অর্থনৈতিক সমীক্ষা ২০২৪ [Bangladesh Economic Review 2024 Bangla.pdf] কম্পিউটার , ট্যাব ও স্মার্ট ফোন ভার্সন সহ সম্পূর্ণ বাংলা ই-বুক বা pdf বই " সুচিপত্র ...বুকমার্ক মেনু 🔖 ও হাইপার লিংক মেনু 📝👆 যুক্ত ..
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How to Setup Warehouse & Location in Odoo 17 InventoryCeline George
In this slide, we'll explore how to set up warehouses and locations in Odoo 17 Inventory. This will help us manage our stock effectively, track inventory levels, and streamline warehouse operations.
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How to Add Chatter in the odoo 17 ERP ModuleCeline George
In Odoo, the chatter is like a chat tool that helps you work together on records. You can leave notes and track things, making it easier to talk with your team and partners. Inside chatter, all communication history, activity, and changes will be displayed.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
land.
The utilization of land is impacted by human needs and environmental factors. In countries
like India, rapid population growth and the emphasis on extensive resource exploitation can lead
to significant land degradation, adversely affecting the region's land cover.
Therefore, human intervention has significantly influenced land use patterns over many
centuries, evolving its structure over time and space. In the present era, these changes have
accelerated due to factors such as agriculture and urbanization. Information regarding land use and
cover is essential for various planning and management tasks related to the Earth's surface,
providing crucial environmental data for scientific, resource management, policy purposes, and
diverse human activities.
Accurate understanding of land use and cover is imperative for the development planning
of any area. Consequently, a wide range of professionals, including earth system scientists, land
and water managers, and urban planners, are interested in obtaining data on land use and cover
changes, conversion trends, and other related patterns. The spatial dimensions of land use and
cover support policymakers and scientists in making well-informed decisions, as alterations in
these patterns indicate shifts in economic and social conditions. Monitoring such changes with the
help of Advanced technologies like Remote Sensing and Geographic Information Systems is
crucial for coordinated efforts across different administrative levels. Advanced technologies like
Remote Sensing and Geographic Information Systems
9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
structure of plant communities across different temporal and spatial scales. These changes can
occur natural.
2. Introduction
• Peripheral neuropathy describes damage
to the peripheral nervous system.
• More than 100 types of peripheral
neuropathy have been identified, each
with its own characteristic set of
symptoms, pattern of development, and
prognosis.
3. • Impaired function and symptoms depend
on the type of nerves
– motor, sensory, or autonomic
• that are damaged.
Introduction
4. • Motor nerves
– control movements of all muscles under conscious
control, such as those used for walking, grasping
things, or talking.
• Sensory nerves
– transmit information about sensory experiences, such
as the feeling of a light touch or the pain resulting
from a cut.
• Autonomic nerves
– regulate biological activities that people do not control
consciously, such as breathing, digesting food, and
heart and gland functions.
Introduction
5. • Although some neuropathies may affect all
three types of nerves, others primarily
affect one or two types.
– Therefore, terms such as
• predominately motor neuropathy
• predominately sensory neuropathy
• sensory-motor neuropathy
• autonomic neuropathy
– are often used to describe a patient's
condition.
Introduction
6. • Because every peripheral nerve has a
highly specialized function in a specific
part of the body, a wide array of symptoms
can occur when nerves are damaged.
• Some people may experience temporary
numbness, tingling, and pricking
sensations (paresthesia), sensitivity to
touch, or muscle weakness.
Introduction
7. • Others may suffer more extreme
symptoms, including burning pain
(especially at night), muscle wasting,
paralysis, or organ or gland dysfunction.
Introduction
8. • People may become unable to digest food
easily, maintain safe levels of blood
pressure, sweat normally, or experience
normal sexual function.
• In the most extreme cases, breathing may
become difficult or organ failure may
occur.
Introduction
9. • Some forms of neuropathy involve
damage to only one nerve and are called
mononeuropathies.
• More often though, multiple nerves
affecting all limbs are affected-called
polyneuropathy.
Introduction
10. • Occasionally, two or more isolated nerves
in separate areas of the body are affected-
called mononeuritis multiplex.
Introduction
11. • In acute neuropathies, such as Guillain-
Barré syndrome, symptoms appear
suddenly, progress rapidly, and resolve
slowly as damaged nerves heal.
• In chronic forms, symptoms begin subtly
and progress slowly.
Introduction
12. • Some people may have periods of relief
followed by relapse.
• Others may reach a plateau stage where
symptoms stay the same for many months
or years.
Introduction
13. • Some chronic neuropathies worsen over
time, but very few forms prove fatal unless
complicated by other diseases.
• Occasionally the neuropathy is a symptom
of another disorder.
Introduction
14. • In the most common forms of
polyneuropathy, the nerve fibers most
distant from the brain and the spinal cord
malfunction first.
• Pain and other symptoms often appear
symmetrically, for example, in both feet
followed by a gradual progression up both
legs.
Introduction
15. Introduction
• Next, the fingers, hands, and arms may
become affected, and symptoms can
progress into the central part of the body.
• Many people with diabetic neuropathy
experience this pattern of ascending nerve
damage.
16. Anatomy
• The body’s nervous system is made up of
two parts.
– The central nervous system (CNS)
– The peripheral nervous system (PNS)
17. Anatomy
• The peripheral nerves include:
– cranial nerves
• (with the exception of the second)
– spinal nerve roots
– dorsal root ganglia
– peripheral nerve trunks and their terminal
branches
– peripheral autonomic nervous system
18. Diagnostic Approach
• The differential diagnosis of peripheral
neuropathy is significantly narrowed by a
focused clinical assessment that addresses
several key issues –
– Does the patient actually have a neuropathy?
– What is the pattern of involvement?
– Is the neuropathy focal, multifocal or symmetric?
– If the neuropathy is symmetric, is it proximal or distal?
19. • Does the patient actually have a neuropathy?
– Causes of generalized weakness include motor
neuron disease, disorders of the neuromuscular
junction and myopathy.
– Peripheral neuropathy can also be mimicked by
myelopathy, syringomyelia or dorsal column
disorders, such as tabes dorsalis.
– Hysterical symptoms can sometimes mimic a
neuropathy.
Diagnostic Approach
20. • Is the neuropathy focal, multifocal or symmetric?
– Focal neuropathies include common compressive
neuropathies such as carpal tunnel syndrome, ulnar
neuropathy at the elbow or peroneal neuropathy at
the fibular head
– A multifocal neuropathy suggests a mononeuritis
multiplex that may be caused, for example, by
vasculitis or diabetes
Diagnostic Approach
21. • If the neuropathy is symmetric, is it proximal or
distal?
– Most toxic and metabolic neuropathies present as a
distal symmetric or dying-back process.
– Proximal sensory neuropathies are rare and include
porphyria.
– Predominantly motor neuropathies are often proximal
and include acquired inflammatory neuropathies such
as Guillain-Barré syndrome.
• An exception is lead neuropathy, which initially affects motor
fibers in radial and peroneal distributions.
Diagnostic Approach
25. • Neuropathies can be categorized
according to the fiber type that is primarily
involved.
• Most toxic and metabolic neuropathies are
initially sensory and later may involve the
motor fibers.
Diagnostic Approach
26. • Pure sensory neuropathies can result from
drug toxicity (e.g., thalidomide, cisplatin
[Platinol]), paraneoplastic syndromes or
nutritional deficiencies.
• Primarily motor neuropathies include
Guillain-Barré syndrome.
Diagnostic Approach
27. • Alcoholism and diabetes can both cause
small-fiber, painful neuropathies
Diagnostic Approach
28. • Autonomic involvement occurs in many
small-fiber neuropathies but can also
occur in Guillain-Barré syndrome and is
sometimes life-threatening.
Diagnostic Approach
29. • It is important to distinguish whether the
neuropathy is axonal, demyelinating, or
both.
• This differentiation is best achieved using
nerve conduction studies (NCS) and
electromyography (EMG).
Diagnostic Approach
30. • Diabetes, HIV infection and alcoholism can
cause several patterns of neuropathy.
• They most commonly cause a distal, symmetric
axonal sensorimotor neuropathy.
• The second most common presentation in these
conditions is a small-fiber, painful neuropathy.
Diagnostic Approach
31. History
• The temporal course of a neuropathy varies,
based on the etiology.
– With trauma or ischemic infarction, the onset will be
acute, with the most severe symptoms at onset.
– Inflammatory and some metabolic neuropathies have
a subacute course extending over days to weeks.
– A chronic course over weeks to months is the
hallmark of most toxic and metabolic neuropathies.
32. History
• A chronic, slowly progressive neuropathy
over many years occurs with most
hereditary neuropathies or with chronic
inflammatory demyelinating
polyradiculoneuropathy (CIDP).
• Neuropathies with a relapsing and
remitting course include Guillain-Barré
syndrome.
33. • Ischemic neuropathies often have pain as
a prominent feature.
• Small-fiber neuropathies often present
with burning pain, lightning-like or
lancinating pain, aching, or uncomfortable
paresthesias (dysesthesias).
History
34. • Dying-back (distal symmetric axonal)
neuropathies initially involve the tips of the
toes and progress proximally in a stocking-
glove distribution.
History
35. • Peripheral neuropathy can present as
restless leg syndrome.
• Proximal involvement may result in
difficulty climbing stairs, getting out of a
chair, lifting and swallowing, and in
dysarthria.
History
36. • The clinical assessment should include:
– careful past medical history, looking for
systemic diseases that can be associated with
neuropathy, such as diabetes or
hypothyroidism.
History
37. • Many medications can cause a peripheral
neuropathy, typically a distal symmetric
axonal sensorimotor neuropathy.
• Detailed inquiries about drug and alcohol
use, as well as exposure to heavy metals
and solvents, should be pursued.
History
38. • All patients should be questioned
regarding
– HIV risk factors
– foreign travel (leprosy)
– diet (nutrition)
– vitamin use (especially B6)
– possibility of a tick bite (Lyme disease)
History
39. • The review of systems may provide clues
regarding other organ involvement and the
presence of an underlying malignancy.
History
41. Physical Examination
• A cranial nerve examination can provide
evidence of mononeuropathies or proximal
involvement.
• Funduscopic examination may show
abnormalities such as optic pallor, which
can be present in leukodystrophies and
vitamin B12 deficiency.
42. • Direct strength testing of muscles
enervated by cranial nerves V, VII, IX/X, XI
and XII is important, as mild bilateral
weakness can be missed by observation
only.
Physical Examination
43. • The motor examination includes a search
for fasciculations or cramps, or loss of
muscle bulk.
• Tone is normal or reduced.
Physical Examination
44. • The pattern of weakness helps narrow the
diagnosis: symmetric or asymmetric, distal
or proximal, and confined to a particular
nerve, plexus or root level.
Physical Examination
45. • Deep tendon reflexes are reduced or
absent.
• A bilateral foot drop may result in a
steppage gait in which the patient must lift
the knees very high in order to clear the
toes.
• Proximal weakness results in an inability
to squat or to rise unassisted from a chair.
Physical Examination
46. • The general physical examination can
provide evidence of orthostatic
hypotension without a compensatory rise
in heart rate when autonomic fibers are
involved.
Physical Examination
47. • Respiratory rate and vital capacity should
be evaluated in Guillain-Barré syndrome to
assess for respiratory compromise.
• The presence of lymphadenopathy,
hepatomegaly or splenomegaly, and skin
lesions may provide evidence of systemic
disease.
Physical Examination
48. • Pale transverse bands in the nail beds,
parallel to the lunula (Mees' lines), suggest
arsenic poisoning.
Physical Examination
49. Laboratory Evaluation
• EMG and nerve conduction studies (NCS)
are often the most useful initial laboratory
studies in the evaluation of a patient with
peripheral neuropathy
50. • They can confirm the presence of a
neuropathy and provide information as to
the type of fibers involved (motor, sensory,
or both), the pathophysiology (axonal loss
versus demyelination) and a symmetric
versus asymmetric or multifocal pattern of
involvement.
Laboratory Evaluation
51. • The limitations of EMG/NCS should be taken
into account when interpreting the findings.
– There is no reliable means of studying proximal
sensory nerves.
– NCS results can be normal in patients with small-fiber
neuropathies
– Lower extremity sensory responses can be absent in
normal elderly patients.
• EMG/NCS are not substitutes for a good clinical
examination.
Laboratory Evaluation
52. • Subsequent studies should be tailored to the most likely
diagnostic possibilities, and to the acuteness and
severity of the neuropathy.
• With an acute progressive neuropathy, a neurologic
consultation early in the course of the evaluation is
essential.
• Further evaluation of these patients includes EMG/NCS,
lumbar puncture, chest radiograph, electrocardiogram
and determination of forced vital capacity.
Laboratory Evaluation
53. • The most common presentation is that of a distal
symmetric sensorimotor neuropathy.
• Initial evaluation should include:
– fasting serum glucose, glycosylated hemoglobin,
blood urea nitrogen, creatinine, complete blood cell
count, erythrocyte sedimentation rate, urinalysis,
vitamin B12 and thyrotropin stimulating hormone
levels.
– Neurologic assessment may be warranted if the initial
evaluation does not produce a diagnosis.
Laboratory Evaluation
54. • CSF is useful in evaluation of
myelinopathies and polyradiculopathies.
• An elevated total protein level with < 5
wbc(albuminocytologic dissociation) is
present in acquired inflammatory
neuropathy (e.g., Guillain-Barré syndrome,
CIDP).
Laboratory Evaluation
55. • Other studies useful in specific clinical
contexts are:
– cytology (lymphoma)
– special studies
• such as Lyme polymerase chain reaction and
cytomegalovirus branched chain DNA
(polyradiculopathy or mononeuritis multiplex in
AIDS).
Laboratory Evaluation
56. • Nerve biopsy is only helpful in very
specific cases to diagnose vasculitis,
leprosy, amyloid neuropathy,
leukodystrophies, sarcoidosis and,
occasionally, CIDP.
Laboratory Evaluation
57. • It can be difficult to document a small-fiber
neuropathy because the only
abnormalities on neurologic examination
may be loss of pinprick and temperature
sensation in a distal distribution.
Laboratory Evaluation
58. • EMG/NCS may be normal.
• Autonomic studies are only helpful if the
autonomic fibers are involved.
• As a result, small-fiber neuropathy
remains a primarily clinical diagnosis.
Laboratory Evaluation
59. • The evaluation should include the most
likely causes (i.e., diabetes, alcoholism,
AIDS).
• If these studies are normal, a neurologic
consultation is recommended.
Laboratory Evaluation
60. Treatment
• The goal of treatment is to manage the
underlying condition causing the
neuropathy and repair damage, as well as
provide symptom relief.
61. Treatment
• Controlling a chronic condition may not
eliminate the neuropathy, but it can play a
key role in managing it.
62. Treatment
• Neuropathic pain is often difficult to control.
• Medications :
– OTC analgesics .
– antiepileptic drugs, including gabapentin, phenytoin,
and carbamazepine
– some classes of antidepressants, including tricyclics
such as amitriptyline.
– Mexiletine
– local anesthetics such as lidocaine or topical patches
containing lidocaine
– Codeine/oxycodone
63. • Mechanical aids can help reduce pain and lessen the
impact of physical disability.
– Hand or foot braces can compensate for muscle weakness or
alleviate nerve compression.
– Orthopedic shoes can improve gait disturbances and help
prevent foot injuries in people with a loss of pain sensation.
• If breathing becomes severely impaired, mechanical
ventilation can provide essential life support.
Treatment
64. • Surgical intervention often can provide
immediate relief from mononeuropathies caused
by compression or entrapment injuries.
– Repair of a slipped disk can reduce pressure on
nerves where they emerge from the spinal cord; the
removal of benign or malignant tumors can also
alleviate damaging pressure on nerves.
– Nerve entrapment often can be corrected by the
surgical release of ligaments or tendons.
Treatment