Peripheral neuropathy 2 main findings? Most common DDx
Arflexia
sensory loss
Differential
* Diabetes
* Alcohol
* B12
* CIDP
* paraneoplastic
* Frederick’s ataxia
* charcot marie tooth (pes cavus and wasting)
* Drugs - Cant Veel PAIN
* If acute - consider GBS
Parkinsonism key exam fidnings?
DDx?
Bradykinesia
Rigiditt
tremor
Postural instabilitty
[reduced expression, reduced arm swing, asymetry]
- Parkinsons Disease
- Vascular parkisinsons
- Drug induced
- Parkinsons plus - PSP, MSA, CBD
- Lew body dementia
- Wilsons
- If tremor only -> Essential tremor, drug induced, dystonic tremor
Spastic paraperisis key findings?
Main Differentials?
Upper motor neurone findings in lower limbs
- Make sure you look at spine
- Increased tone / clonus
- Weakness
- Waiding gait
Demyelinating eg MS
Cord comression
Hereditary - spastic paraperesis
Spinal stroke
Cerebellar syndrome
DDx
My HAND VP
- MS
- Hereditary - Spinocerebella ataxia (esp brisk reflexes), Frederick’s / Ataxia telangectasia
- Alcohol
- Nutritional b1/12
- Drugs - phenytoin
- Vascular - stroke
- Paraneoplastic / Posterior fossa lesion
Hemiplegia DDx
- Vascular - Thrombosis, haemorrhage, embolism
- Tumour / SOL
MND differentials
- Cervical cord compression
- Motifocal motor neuropathy with conduction block
- Demyelination
- Kennedy
Myotonic vs Fascioscapulohumeral vs Inclusion body myosistis
Myotonic - myotonia, frontal balding, cataracts
FS - Weakness in face, shoulders, upper limbs, scapular. winging
Inclusion body - weakenss Finger flexors and kene extensors
ptosis cause unilateral? bilateral?
Uni
- CN3 palsy (normal / big) , horners (small pupil)
- Look for forhead sparing or not
Bilat
- myaesthenia, myopathy eg myotonic dystrophy
