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1、周围神经病PeripheralNeuropathy中国协和医科大学Peripheralneuropathyisalargegroupofdiseases:Damageofnervesoutsideofthespinalcordandbrain.Dysfunctionofthesenerves.CausedbyanyofriskfactorsAnatomyandfunctionofperipheralnerve——basictounderstandneuropathyAnatomycranialnerveolfactorynerveopticnerveoculom
2、otornervetrochlearnervetrigeminalnerveabducentnervefacialnervevestibulocochlearnerveglossopharyngealnervevagusnerveaccessorynervehypoglossalnerveSpinalnervesHistologyElectrophysiologyUnmyelinatednervefiberMyelinatednervefiberFunctionsMotornerveSensorynerveAutonomicnervereflexStep1:Cl
3、inicalfeaturesofneuropathies——historyandexaminationofpatientisthecluestodiagnosisofneuropathyMuscleweaknessWeaknessinthearmsorlegs：difficultywalking,running,climbstairs,Stumblingortiringeasily.Difficultieswithcarryingaloadofgroceries,openingjars,turningdoorknobs,orcombinghair.Cranial
4、nerveparalysis:ophthalmoplegia,facialweakness,dysarthria,RespiratoryinsufficientMuscleatrophy.Reflexlost.tips:LowermotorneurogenicdamageAnatomicdistributionSymmetricproximaldistalAsymmetricsinglenerve multiplenerve plexus nerverootSensoryabnormalitiesParesthesiasSpontaneoussensations
5、,numbness,tingling,pinsandneedles,prickling,burning,cold,pinching,sharpdeepstabs,andelectricshocksorbuzzing.DysesthesiasUnpleasantabnormalsensationsbroughtonbytouchingorotherstimuli.Anesthesiaalackofsensation,leadingtoinjuries,cutsandburnsduetothelackofnormalwarningsensations.alackof
6、sensationofposition,whichleadstouncoordinatedandunsteadywalking.tips:Hearingpatient’sdescriptionAnatomicdistributionSymmetric“GloveandStocking”distributionAsymmetricsinglenervemultiplenerveplexusnerverootAutonomicNerveDamageblurredvisiondecreasedabilitytosweat(anhidrosis)decreasedabi
7、litytoregulatebodytemperaturedisturbancesofbladderfunctionorthostatichypotensionConstipationdiarrhea,nauseaaftermeals,abdominalbloatingsexualdysfunction(impotence)thinningoftheskin,witheasybruisabilityandpoorhealing.Step2:Laboratoryfindingsnerveconductionstudycanconfirmneuropathyandd
8、istinguishbe
