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Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e
Chapter 166. Acute Peripheral Neurologic Lesions
Sections: Acute Peripheral Neurologic Lesions: Introduction, Approach to the Patient: Distinguishing Central and Peripheral Lesions, Approach to the Patient: Localizing Peripheral Neurologic Disorders, Treatment: General Considerations, Acknowledgment, References.
Topics Discussed: peripheral nervous system neoplasms.
Excerpt:"Acute peripheral neurologic lesions are a diverse group of disorders.
By definition, they involve injury or disease in sensory and motor
fibers outside of the central nervous system (CNS) extending to
the neuromuscular junction. The peripheral nervous system (PNS)
serves sensory, motor, and autonomic functions. The patient with
a peripheral nerve lesion thus may have symptoms reflecting a disorder
of any or a combination of these functions. Sensory symptoms may
include numbness, tingling, dysesthesias, pain, or ataxia. Motor
symptoms manifest as weakness. Autonomic disability may be noted
as orthostasis, bowel or bladder dysfunction, gastroparesis, or
sexual dysfunction. Acute peripheral neurologic processes may be
due to Guillain-Barré syndrome, botulism, tick paralysis,
focal compression, plexopathy, human immunodeficiency virus (HIV)
disease, diabetic peripheral neuropathy, or others. Painful neuropathies
alone are seen in approximately 15% of diabetics, 35% of
HIV-positive patients, and 23% of patients with multiple
sclerosis.1 Guillain-Barré syndrome or botulism
has the potential to cause respiratory failure, so prompt recognition
and treatment of these diseases is important. Most important, central
processes, such as..."
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