-
Neuropraxia
(Seddon 1st degree)
- Compression w/ local conduction block
- No structural damage
- Local demyelination
- Motor loss only (sense+auto OK)
- Prog: Good.
-
Axononotmesis
(Seddon 2nd degree)
- Prolonged severe compression
- Degen of axon distal to injury
- Endoneural tube intact
- Sense+Motor+Auto loss
- Prog: Good (tube is intact to guide regrowth)
-
Neurotmesis
(Seddon 3rd degree)
- Severance of part/all of trunk
- Endoneural tube severed
- Degen of NN
- Scar tissue @ site prevents regen
- Sense+Motor+Auto loss
- Prog: Poor (no tube to guide regen)
-
Neuritis
- Inflammation of a NN
- Affects sheath and CT, but not Axon
- Constant dull pain
- Parethesia/Dysthesia may be present
- May have Motor+Sense loss if long duration
- Causes: Trauma, chronic exposure to toxin (booze, drugs, lead), 2nd to pathology (diabetes, leprosy, TB)
-
Neuralgia
- No appeciable pathological changes
- Recurrent attack of sudden pain along NN distribution
- Causes: Local compression, trauma, inflammation, scar tissue, subluxed veretebra, prolonged exposure to cold
-
Causalgia
- Severe Pain syndrome
- sudden onset
- Persistent burning
- Often due to trauma
- Often incomplete w/ arterial injury
- Cause: Bullets, surgery, injections, electrocution, amputation
-
RSD/CRPS
- Pain syndrome
- Abnormal SNS reflex => arterial spasm
- Spontaneous burning pain distal to NN injury, out of proportion to injury
- Edema w/ dystrophic tissue
- Pain increased by RoM/emotions
- Warm+hyperemic or cool+pale
- Sweating usually increased with MM wasting
- "minor causalgia"
-
Neuromas
- Tumor composed of NN cells
- Post partial/complete severance of NN
- Random NN sprouts form random clumped masses
- Sml+compact= lesspainful
- large+soft= more painful
-
Regeneration rates
- Avg 10 days
- 1-2mm per day, proximal side grows faster
- Delay of 18 days to produce MM contraction
- Can cause X-innervation (+mixed NNs)
- Alcoholism/metal poisoning worsens prognosis
-
Deep Tendon Reflex Grading
- 0 - Absent
- 1 - Diminished
- 2 - Average (normal)
- 3 - Exaggerated
- 4 - Clonus or Very Brisk
-
Reflex for the Jaw
CNS Segment?
C5
-
Reflex for the Biceps
CNS Segment?
C5-6
-
Reflex for the Triceps
CNS Segment?
C7-8
-
Reflex for the Patella
CNS Segment?
L3-4
-
Reflex for the Achilles
CNS Segment?
S1-2
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