Pain Syndromes
Complex Regional Pain Syndrome (RSD)
Radicular Pain
Vitamin B12 Deficiency
Copper Deficiency
Syringomyelia
CLINICAL FINDINGS
AUTONOMIC DISTURBANCES
Postural hypotension - esp in diabetic polyneuropathy
NERVE PAIN RELIEF
topical capsaicin
Phenytoin/carbamazepine/mexiletine
gabapentin/lamotrigine/topiramate
amitriptyline
Pregabalin
Duloxetine/ Venlafaxine (SNRI)
INVESTIGATIVE STUDIES
NCV
EMG
Enlarged nerves
Autonomic disturbances
Tendon Reflex
Impaired or lost if reflex arcs are interrupted.
Motor Deficits
Dissociated Sensory Loss
Dissociated sensory loss involves impairment of some sensory modalities such as pain and temperature with preservation of others such as light touch, vibration and joint space position (proprioception).
Can occur in spinal cord injuries but also in peripheral neuropathies.
Pain
The precise mechanism of its genesis is unclear.
Sensory Disturbances
Sensory fiber involvement can lead to numbness and impaired sensation; abnormal spontaneous sensations such as paresthesia.
Sensory Disorders
Peripheral Nerve Lesions/ Peripheral Neuropathies
Mononeuropathies
Entrapment Neuropathies
Polyneuropathies
Infective and Granulomatous Neuropathies
Metabolic/ Nutritional Neuropathies
Myelinopathy - demyelinating
some paraneoplastic disease
Diphtheria
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)
Guillain Barre Syndrome
https://www.youtube.com/watch?v=c-8ia81XPMw
Axonal Neuropathy
Nerve Root/Plexopathies
Lyme Disease
Tabes Dorsalis
Lumbosacral Plexopathy
Brachial Plexopathy
Thalamus
Relay center of the brain. Everything goes through the thalamus.
Brainstem
Parietal Lobe/Sensory Cortex
Spinal Cord Lesion
MYELOPATHY - deficit related to the cord
Anterior/Posterior Cord
Central Cord
Hemicord
