Paraesthesia
Symmetrical
Asymmetrical
Distal
Proximal
DM
- mx: gabapentin 300mg TDS/TCA
- refer NEM if very pain/cannot walk
Vit B12 deficiency
- sensory, vibration/proprioception loss
GBS
Drugs
CMT
spinal cord
transverse myelitis
syringomyelia
- cape-like distribution
- motor, pain, temperature
disc prolapse
spondylosis/ fracture/ multiple myeloma/ bone mets
patchy
non-patchy
one patch
multiple patches
Mononeuropathy/ nerve entrapment
- motor signs
plexus
radiculopathy
mononeuritis multiplex
DM, polyarthritis nodosa (autoimmune), sarcoidosis, amyloidosis
- asymmetrical random patches
- paraesthesia and weakness
sensory neuropathy
drugs - platinum, aminoglycoside (GNAT)
- motor spared
- areflexia & ataxia
conus medullaris
UMN
sensory cortex
lateral medullary syndrome
thalamus (pure sensory stroke - VPL of thalamus)
Tabes Dorsalis
- vibration/ proprioception
- tertiary syphillis
- argyll robertson pupils
Brown-sequard syndrome
Hypocalcemia
STROKE/TIA/migraine
External compression (physical, tumour)
carpal tunnel syndrome
CNS (primary headache/secondary headache)
spinal cord
Higher cortical signs and symptoms
- aphasia, neglect, abnormalities of graphesthesia, stereognosis, two-point discrimination, extinction
Axonal (length-dependent) neuropathies:
- DM, leprosy
- hereditary conditions ((eg, Charcot-Marie-Tooth disease)
- Amyloidosis (light chain and familial)
- Vasculitis
- Uremia
- Chemo, EtOH
- paraneoplastic neuropathy
- nutritional deficiency (vit B2, B6, B12)
- infections (HBV, HCV, syphillis, HIV, lyme disease)
Hyperventilation/ panic attack
PVD
Carpal tunnel syndrome
- worse in morning, better with shaking
- can involve all 5 fingers
- refer HRM
PSY: https://neurosymptoms.org/en/
- refer psychology