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Mononeuropathy (Nerves (Lower limb (Common peroneal (L4-S1) (Aetiology …

- - - - Clinical presentation
        Sensory symptoms (little finger, lateral ring finger, medial hand)
        Later, LMN weakness (small muscles), hypothenar wasting
        Late claw hand of little/ring (hyperextension MCP, flexion ICP)
      - Diagnosis
        
        History
        Occupation: painters,
        bricklayers, secretaries, etc.
        
        Examination
        Froment's +ve
        
        Investigations
        NCS (delayed)
      - Aetiology
        Trauma (fracture, dislocation
        at epicondylar groove of elbow)
        Iatrogenic (after GA)
        Degenerative (OA)
      - Management
        
        Conservative
        Avoid aggrevators
        
        Surgical
        Ulnar nerve decompression
        Nerve transposition
    - - Clinical presentation
        Wrist drop (weak dorsiflexion and finger ext at MCPs)
        Sensory loss (over dorsal 1st interossei)
      - Diagnosis
        
        History
        Trauma, alcohol
        
        Examination
        Weak dorsiflexion and finger ext MCPs
        Sensory loss over dorsal 1st interossei
        
        Investigations
        NCS
      - Aetiology
        Trauma (saturday night palsy, fractured
        humerus shaft, axilla crutch trauma)
        Iatrogenic (post-anaesthetic)
      - Management
        
        Conservative
        Physiotherapy
        Splints
    - - Aetiology
        Trauma
        Autoimmune (RA, sarcoid, amyloid)
        Idiopathic (most common)
        Neoplastic (myeloma, lipomas)
        Drugs (OCP)
        Degenerative (OA)
        Enfocrine (DM, acromegaly,
        hypothyroid, pregnancy)
      - Clinical presentation
        Sensory loss lateral 3 fingers,
        worse at night, relieved by shaking hands
        Later, LMN weakness (LOAF) and wasting of thenars
      - Epidemiology
        Commoner in women
        (smaller crossectional area
        in carpal tunnel)
      - Diagnosis
        
        History
        
        Examination
        Tinel's test +ve
        Phelan's test +ve
        
        Investigations
        Bloods (FBC, CRP/ESR, glucose, U+E,
        LFT, TFT, autoimmune - RF, ANA etc.)
        NCS (slowing of signal)
      - Management
        
        Conservative
        Splinting
        
        Medical
        Diuretics
        Local steroid injection
        
        Surgical
        Carpal tunnel release
  - - - Aetiology
        Trauma (pelvic/femur fractures)
        Neoplastic (pelvic tumour)
      - Clinical presentation
        LMN weakness (hamstrings, lower leg, foot drop)
        Sensory loss (lateral below knee)
    - - Aetiology
        Trauma (fibula head, sit crosslegged, cauda equina)
        Peripheral neuropathy (DM etc.)
        Degenerative (MND)
      - Clinical presentation
        LMN weakness (foot drop, weak ankle dorsiflexion/eversion)
        Sensory loss (dorsum of foot)
        Preserved ankle reflexes
        High steppage gait
      - Diagnosis
        NCS
      - Management
        Physio, OT, splints
        Surgical intervention
    - - Aetiology
        Trauma
      - Clinical presentation
        LMN waekness (plantarflexion, invert foot, flex toes)
        Sensory loss (dorsum of foot)
    - - Aetiology
        Trauma (inguinal ligament)
      - Clinical presentation
        Sensory change (pain/loss i
        n anterolateral thigh)
  - - - Clinical presentation
        Dyspnoea, orthopnoea
      - Diagnosis
        
        History
        
        Examination
        
        Investigations
        CXR (raised hemidiaphragm)
      - Aetiology
        Infection (C3-5 hepes zoster, HIV, Lyme, TB)
        Trauma (C-spine trauma)
        Autoimmune (MS)
        Iatrogenic (post-surgery)
        Neoplastic (lung ca, thymoma, myeloma, paraneoplastic)
        Degenerative (cervical spondylosis, muscular dystrophy)