Peripheral neuropathies

Mind Map by , created almost 6 years ago

paeds-neurology Mind Map on Peripheral neuropathies, created by v.djabatey on 01/12/2014.

Created by v.djabatey almost 6 years ago
Epilepsies of childhood
Peripheral motor disorders- neuromuscular disorders
Epilepsies of childhood-pt2
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Andrea Leyden
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Primary headaches
The inflammatory myopathies
Myotonic disorders
Secondary headaches- raised ICP & space-occupying lesions
Peripheral neuropathies
1 Hereditary motor sensory neuropathies
1.1 -> symmetrical slowly progressive distal muscular wasting
1.2 type I
1.2.1 aka peroneal muscular atrophy (Charcot-Marie-Tooth disease)
1.2.2 dominantly inherited
1.2.3 commonest type
1.2.4 affected nerves hypertrophy due to demyelination fb attempts @ remyelination so nerve biopsy shows 'onion bulb formation'
1.2.5 onset 1st decade presentation distal atrophy pes cavus legs> arms affected distal sensory loss & diminished reflexes rare loss of walking ability is rare initial presentation of Friedreich ataxia can be similar
1.2.6 chronic course
2 acute post-infectious polyneuropathy (Guillain-Barre syn)
2.1 presentation
2.1.1 2-3 weeks ff upper resp tract infection campylobacter gastroenteritis
2.1.2 fleeting abnormal sensory sx in legs
2.1.3 prominent feature ascending symmetrical weakness w/ loss of reflexes & autonomic involvement
2.1.4 sensory sx in distal limbs
2.1.5 bulbar mm involvement difficulty chewing & swallowing risk of aspiration
2.1.6 max mm weakness occurs 2-4 weeks after onset of illness
2.2 full recovery expected in 95% of cases
2.2.1 may take up to 2 years
2.3 Ix
2.3.1 CSF protein sig raised characteristic may not be seen till 2nd wk of illness
2.3.2 CSF WCC not raised
2.3.3 nerve conduction velocities reduced
2.4 Mx
2.4.1 supportive respiration ventilator
2.4.2 NOT USEFUL corticosteroids
2.4.3 immunoglobulin infusion reduce time on ventilator if unsuccessful use plasma exchange
3 Bell palsy & facial nerve palsies
3.1 Bell's palsy
3.1.1 isolated lower motor neurone paresis of CN7 -> facial weakness
3.1.2 aetiology unclear but probably post-infectious assoc w/ herpes simplex in adults
3.1.3 Mx Rx corticosteroids to reduce oedema in the facial canal during the 1st week NO USE aciclovir
3.1.4 recovery may take several months
3.1.5 complications conjunctival infection caused by incomplete eye closure on blinking eye protection or tarsorrhaphy
3.1.6 differential diag features of Bell's + sx of CN7 paresis compressive lesion in cerebellopontine angle most likely diag painful vesicles on tonsillar fauces, external ear due to HSV invading geniculate ganglion Rx = aciclovir hypertension cos assocn btw Bell's palsy and coarctatin of aorta if facial weakness bilat sarcoidosis Lyme disease

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