Inherited

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Inherited

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1. Inherited HMSN-hereditary motor sensory neuropathy Type I –distal limb weakness,wasting (mainly peroneal) DTR depressed (ankle almost always) some sensory loss in majority peripheral nerve enlargement in 1/3 EP?demyelinating picture SNB?onion-bulb demyelination

2. Acquired neuropathy Inflammatory Connective tissue diseases RA,SLE,PAN?vasa nervosa arteritis symmetric distal sensory multinuritis multiplex mononeuropathy SNB?fibrinoid arteritis

3. metabolic Diabetic neuropathy (commonest) symmetrical distal sensory (commonest) ?reduced V/P,DTR distal pain,paresthesia,charcot joint asymmetrical proximal motor ?thigh weakness/wasting mono/multiple neuritis multiplex autonomic neuropathy Thyroid/parathyroid disorder Renal/hepathic failure Vitamin deficiency (B1,6,12)

4. Mononeuropathy entrapment Median nerve carpal tunnel syndrome patients have smaller canal ?nocturnal pain,numbness in fingers sensory loss over lateral 3 ½ weakness/wasting of thenar positive Tinel`s/Phalen`s sign reduced SAP, distal motor latency Proximal median lesion Anterior interosseous br.entrapped at pronator teres head?pain in forearm Flexor and weak(FPL,FDP)? weak grip/thumb,2nd ,3rd finger flexion No sensory loss

5. Ulnar nerve Cubital tunnel syndrome-entrapped by FCU ?pain from elbow to ulnar hand side claw hand-due to weak 4th ,5th lumbricals weakness/wasting of hypothenar,interossei,adductor policis sensory loss of ulnar 1 ½ EP-slow motor CV across elbow

6. Radial nerve saturday night palsy- compressed around spiral groove weak wrist,finger extensors brachioradials,supinator(spare triceps) slight sensory loss posterior interosseous palsy compressed through supinator pain in elbow /forearm weakness of wrist,finger extensor radial deviation on wrist extension (due to spared radial extensor)

7. Thoracic outlet syndrome C8 orT1(lower trunk) compressed by cervical rib (fibrous band) ?pain over ulnar forearm/hand, weakness/wasting of thenar/ulnar muscles wasting /sensory loss on medial forearm symptoms worse by down arm traction CXR-breaking C7 transverse process SSER?reduced amplitude increase latency of N9,N13

8. Brachial plexus lesions damaged by irradiation,trauma,tumor ?pain in upper plexus distribution global weakness/wasting of arm may show Horner`s Brachial plexopathy (neuralgic amyotrophy) induced by infection,trauma,surgery ?severe shoulder pain followed by weakness/wasting of deltoid/spinati winging scapula

9. Peroneal nerve compressed around fibular neck by trauma or prolonged immobility ?weakness/wasting of foot evetors and foot/toes extensors (mainly EHL) DTR spared sensory over dorsal foot/lateral calf Tibial nerve Tursal tunnel syndrome compressed post.tibial at tursal tunnel ?pain.pareesthesiae in sole percussion behind med.malleolus triger the pain EP-absent medial planter SAP Digital neuropathy compressed interdigital nerves between metatarsal heads?pain at distal foot/toes

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