1. Peripheral Neuropathy Dr.Shamekh M. El-Shamy

2. Peripheral Neuropathy Peripheral Neuropathy  DEFINITION: It is inflammation and degeneration of the peripheral nerves and/or the cranial nerves resulting in impairment of the conductivity of these nerves It is inflammation and degeneration of the peripheral nerves and/or the cranial nerves resulting in impairment of the conductivity of these nerves

3. Classification of Neuropathy Classification of Neuropathy 1- Mononeuropathy: 2- Mononeuropathy multiplex: 3- Polyneuropathy:

4.  CAUSES OF MONONEUROPATHY : 1- Trauma: wrong injection into a nerve, callus compression. 2- Infective: leprosy, herpes zoster. 3- Vascular: polyarteritis nodosa. 4- Metabolic: diabetes mellilus.

5. CAUSES OF POLYNEUROPATHY CAUSES OF POLYNEUROPATHY I-Heridofamilial: 1- Hypertrophic interstitial polyneuropathy. 2- Peroneal muscle atrophy. 3- Refsum's disease.

6. Clinical Picture of polyneuropathy Clinical Picture of polyneuropathy A- Motor:

7. B- Sensory: B- Sensory:

8. Glove Stock Hypothesia

9. C-Autonomic:  Vasomotor: coldness and cyanosis of the limbs.  Cutaneous: loss of hair, brittle nails, trophic ulcers.

10. Specific Types of Polyneuropathy I- PERONEAL MUSCLE ATROPHY

11. Peroneal muscle Atrophy Peroneal muscle Atrophy Inverted Champagne-bottle appearance

12. Diabetic Neuropathy Diabetic Neuropathy  Pathogenesis:  Diabetic microangiopathy of the vasa nervosa.  Ischaemia of the nerves, 2ry to atherosclerosis of the vasa nervosa.

13. Treatment of Diabetic Neuropathy  Proper management of diabetes: diet, oral hypoglycaemic drugs or insulin.  VilaminsB1 100 mg daily, B6 200 mg daily, B 12 1000 mg daily.

14. Acute Infective Polyneuropathy Landary-Guillan-Barre Syndrome Acute Infective Polyneuropathy Landary-Guillan-Barre Syndrome  Aetiology: It is due to an allergic or auto-immune reaction secondary to a previous non- specific virus infection.

15. Clinical Picture Clinical Picture 1-Febrile stage: 2-Latent stage:

16. 3-Paralytic stage: 3-Paralytic stage:

17. PN Testing for diagnosis The EMG test itself:  Nerve Conduction Studies (NCS)  EMG (Needle portion)

20. Treatment of Guillain Barre Syndrome Treatment of Guillain Barre Syndrome

21. Thank you