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1、周围神经病PeripheralNeuropathyPeripheralneuropathyisalargegroupofdiseases:Damageofnervesoutsideofthespinalcordandbrain.Dysfunctionofthesenerves.CausedbyanyofriskfactorsAnatomyandfunctionofperipheralnerve——basictounderstandneuropathyAnatomycranialnerveolfactorynerveopticnerveoculomotornervetrochlea
2、rnervetrigeminalnerveabducentnervefacialnervevestibulocochlearnerveglossopharyngealnervevagusnerveaccessorynervehypoglossalnerveSpinalnervesHistologyElectrophysiologyUnmyelinatednervefiberMyelinatednervefiberFunctionsMotornerveSensorynerveAutonomicnervereflexStep1:Clinicalfeaturesofneuropathi
3、es——historyandexaminationofpatientisthecluestodiagnosisofneuropathyMuscleweaknessWeaknessinthearmsorlegs：difficultywalking,running,climbstairs,Stumblingortiringeasily.Difficultieswithcarryingaloadofgroceries,openingjars,turningdoorknobs,orcombinghair.Cranialnerveparalysis:ophthalmoplegia,faci
4、alweakness,dysarthria,RespiratoryinsufficientMuscleatrophy.Reflexlost.tips:LowermotorneurogenicdamageAnatomicdistributionSymmetricproximaldistalAsymmetricsinglenerve multiplenerve plexus nerverootSensoryabnormalitiesParesthesiasSpontaneoussensations,numbness,tingling,pinsandneedles,prickling,
5、burning,cold,pinching,sharpdeepstabs,andelectricshocksorbuzzing.DysesthesiasUnpleasantabnormalsensationsbroughtonbytouchingorotherstimuli.Anesthesiaalackofsensation,leadingtoinjuries,cutsandburnsduetothelackofnormalwarningsensations.alackofsensationofposition,whichleadstouncoordinatedandunste
6、adywalking.tips:Hearingpatient’sdescriptionAnatomicdistributionSymmetric“GloveandStocking”distributionAsymmetricsinglenervemultiplenerveplexusnerverootAutonomicNerveDamageblurredvisiondecreasedabilitytosweat(anhidrosis)decreasedabilitytoregulatebodytemperaturedisturbancesofbladderfunctionorth
7、ostatichypotensionConstipationdiarrhea,nauseaaftermeals,abdominalbloatingsexualdysfunction(impotence)thinningoftheskin,witheasybruisabilityandpoorhealing.Step2:Laboratoryfindingsnerveconductionstudycanconfirmneuropathyanddistinguishbetweendam
