Top Tweets for #PT546Week3
#PT546week3 Horizontal diplopia worse at distance? Verdict: Cranial Nerve 6 Palsy. Kudos to Fletcher 👏 https://t.co/467oEkNEkC
We learned about Peripheral Neuropathies today so remember if your patient has incontinence or urinary retention, it is most likely not CIDP, GBS or a peripheral neuropathy... be Nancy Drew and find out the true Diagnosis. #PT546week3 @juliehershberg
Be still my nerd ❤️. Star Wars and Neuropath differential diagnosis in one tweet. #PT546week3 https://t.co/apYZlVqL0v
Nerve Wars Episode 2: Attack of the Schwann Cells
There is unrest in the axon. Several Schwann cells have declared intentions to attack the myelin sheath resulting in polyneuropathy... #CIDP #AutoimmuneEtiology #PT546Week3 @juliehershberg
Peripheral neuropathy’s all involve LMN’s, distal>proximal weakness and sensory & motor loss. Then how do we differentiate between GB, diabetic neuropathy and CIDP? ⏰was the 🗝to dx CIDP! #PT546week3 @juliehershberg
Usain Bolt’s 100m World Record: 12.27 m/s
He may be the fastest man alive, but if can beat your nerves in a race, you may have CIDP. Healthy nerve conduction velocities should fall within 40-60 m/s!
Make sure your nerves are in gold medalist shape
#PT546week3 @juliehershberg
#PT546week3 were you all 🤔 💭 about that ⬆️d CSF glucose? There are NO NORMATIVE VALUES. Check the RATIO of CSF glu to blood glu taken at similar ⏰. Should be ~2/3. Lower? You may have an infxn or inflam process consuming that CSF glu. #themoreyouneuro (@juliehershberg)
Anyone else experiencing déjà vu? It might be MS....kidding! It's CIDP again!
Remember motor and sensory symptoms, pattern of symptoms, time course of onset, and to do diagnostic tests and you'll be good. @juliehershberg #PT546week3
#PT546week3 Anything is possible in neuro! Suspected CIDP for a patient with gradual progressive weakness, numbness, & diplopia. Diagnosis was confirmed with EMG/NCV and CSF studies. Usually there is a turn of events, but this time our suspicions were correct! @juliehershberg
Think your pt may have a polyneuropathy? NCV is the gold standard for diagnosis! #PT546week3 @juliehershberg
Stocking-glove pattern of sensory loss is a common finding in patients with polyneuropathy 🧦🧤identifying patterns of weakness and reviewing the pt’s symptom timeline gives you a better shot at tackling your list of differential dxs @juliehershberg @HaniehAmoozegar #PT546week3
🚧Gradual onset of numbness in B feet doesn’t always indicate diabetic peripheral neuropathy🚧
👮🏽♀️👉🏽CIDP can also present with distal to proximal neuropathy
#PT546week3
Electrophoresis and tracking the duration of symptoms can help with deciding between GBS and CIDP. Timeline 👏🏾 Timeline 👏🏾 Timeline 👏🏾 #PT546week3
Progressive weakness for over 2 months?
Motor and sensory deficits but no UMN signs?
Elevated protein concentration but normal cell count?
Slowed nerve conduction velocity?
CIDP, I CHOOSE YOU!
#PT546week3 @juliehershberg
The time frame still matters! If the patient is presenting with symmetrical weakness, sensory deficits, and eye involvement.. CIDP might be your diagnosis! Confirm your hypothesis with CSF and ENMG tests. #PT546week3 @juliehershberg
GBS, a rapidly demyelinating disease. Fear not, with IVIG treatment and strength rehab, recovery is possible. You’ll be back to normal activities in no time! #PT546week3 @juliehershberg
It is week 3 in Neuropathology, and with minimally sufficient confidence I am able to differentiate the differences between CNS, PNS, UMN, LMN, GBS, CIPD, and DN. #PT546Week3 #MoreMentalGymnastics @juliehershberg
#PT546week3 If CIDP is at the top of your differential diagnosis list, which tests will give you the most bang for your buck? CSF electrophoresis and NCS might be your best bet! @juliehershberg
Episodic, symmetrical weakness, sensory involvement..thinking CIDP..but wait! Prox weakness> distal..uh oh is it a myopathy..don’t go on a tangent, all other s/s + Lab findings point to CIDP. Trust your gut & remember “It’s Neuro, so it’s all possible”@juliehershberg #PT546week3
Today’s pt presented symmetrically weak
Along with dysfunctions in her recti & oblique 👀
Between CIDP & MS, we were pretty torn
And contemplated her findings over some popcorn 🍿🤔
After testing CSF & NCS,
We confirmed CIDP was the correct guess 🙈
#PT546week3 @juliehershberg
Peripheral neuropathies—Guillain Barre vs. CIDP vs. Diabetic Neuropathy?
Timeline is important. Distal to proximal sx, motor/sensory involvement that has gone on for months episodically, NCS/EMG/CSF results may help confirm CIDP!
#PT546week3 @juliehershberg
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