Polyneuropathy causes, Guillain-Barre, myasthenia gravis, ALS, myopathies, and entrapment neuropathies with distinguishing exam findings.
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- What is the most common cause of peripheral polyneuropathy in developed countries?
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Diabetes mellitus.- Vitamin B12 deficiency causes a polyneuropathy associated with what spinal cord condition?
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Subacute combined degeneration (dorsal columns and corticospinal tracts).- Through what two mechanisms does chronic alcohol use cause polyneuropathy?
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Direct ethanol neurotoxicity and thiamine (vitamin B1) deficiency.- Chronic lead toxicity classically causes a motor neuropathy presenting with what exam finding?
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Wrist drop.- Which two chemotherapy drug classes commonly cause a sensory-predominant peripheral neuropathy?
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Platinum-based agents (such as cisplatin) and vinca alkaloids (such as vincristine).- What is the classic sensory distribution of a length-dependent polyneuropathy?
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Symmetric stocking-glove pattern, starting in the feet and progressing proximally.- On nerve conduction studies, how does axonal polyneuropathy differ from demyelinating polyneuropathy?
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Axonal neuropathy shows reduced amplitude with relatively preserved conduction velocity; demyelinating neuropathy shows markedly slowed conduction velocity.- What is the inheritance pattern of Charcot-Marie-Tooth disease type 1A?
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Autosomal dominant, caused by duplication of the PMP22 gene.- What antecedent infection is most commonly associated with Guillain-Barre syndrome?
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Campylobacter jejuni gastroenteritis.- What is the classic cerebrospinal fluid finding in Guillain-Barre syndrome?
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Albuminocytologic dissociation (elevated protein with a normal white blood cell count).- What is the typical pattern of weakness progression in Guillain-Barre syndrome?
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Ascending, symmetric weakness that starts in the legs and moves upward.- What happens to deep tendon reflexes in Guillain-Barre syndrome?
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They are diminished or absent (areflexia).- What pulmonary function test is used to monitor for impending respiratory failure in Guillain-Barre syndrome?
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Forced vital capacity (FVC).- What are the two first-line treatments for Guillain-Barre syndrome?
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Intravenous immunoglobulin (IVIG) and plasma exchange (plasmapheresis).- What clinical triad characterizes the Miller Fisher variant of Guillain-Barre syndrome?
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Ophthalmoplegia, ataxia, and areflexia.
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