FINAL YEAR MBBS | KMU CURRICULUM
AIM Student Memory Support
Topic 10: Acquired & Hereditary Neuropathies
Neuroscience Module | Medicine & Pediatrics
High-Yield Revision • Clinical Associations • KMU Examination Focus
1. High-Yield Flashcards
Tap each question to reveal the answer.
What is the difference between mononeuropathy and polyneuropathy?
Why does length-dependent polyneuropathy begin in the feet?
Which sensory abnormalities distinguish small-fibre from large-fibre neuropathy?
What nerve conduction abnormality suggests axonal neuropathy?
Which nerve conduction findings suggest demyelinating neuropathy?
Which clinical pattern suggests diabetic distal symmetric polyneuropathy?
What is the characteristic presentation of Guillain–Barré syndrome?
What CSF finding supports Guillain–Barré syndrome?
Which disease-modifying therapies are used in Guillain–Barré syndrome?
What clinical time course helps distinguish CIDP from typical GBS?
Which childhood findings suggest Charcot–Marie–Tooth disease?
What is the main pathological distinction between CMT1 and CMT2?
Which genetic abnormality is a classic cause of CMT1A?
What is hereditary neuropathy with liability to pressure palsies (HNPP)?
What is the primary goal of managing common hereditary neuropathies?
2. Mnemonics
Mnemonic 1 — Important Acquired Causes
Mnemonic Word: DINT
Meaning:
- D — Diabetes and other metabolic diseases
- I — Inflammatory and infective causes
- N — Nutritional deficiencies
- T — Toxins and drugs
A compact recall aid for major systemic acquired causes. Focal nerve entrapment is another important category.
Mnemonic 2 — Peripheral Neuropathy Assessment
Mnemonic Word: DART
Meaning:
- D — Distribution: focal, multifocal or symmetric
- A — Axonal or demyelinating mechanism
- R — Reflex and sensory-motor findings
- T — Time course: acute, subacute or chronic
Mnemonic 3 — Childhood CMT Recognition
Mnemonic Word: FEET
Meaning:
- F — Foot drop and frequent falls
- E — Elevated foot arch (pes cavus)
- E — Extensor weakness and distal wasting
- T — Tendon reflexes reduced, especially ankle jerks
3. Memory Tables
Axonal versus Demyelinating Neuropathy
| Feature | Axonal | Demyelinating |
|---|---|---|
| Primary injury | Nerve axon | Myelin sheath |
| Nerve conduction | Reduced response amplitude | Marked slowing; possible conduction block |
| Typical examples | Many diabetic neuropathies; CMT2 | CIDP; CMT1 |
| Diagnostic implication | Loss of functioning fibres | Impaired electrical conduction |
Both axonal and demyelinating mechanisms can occur in acquired or hereditary neuropathies.
4. Rapid Revision Points — Last-Minute Revision
Must Remember:
- Stocking–glove sensory loss indicates length-dependent polyneuropathy.
- Mononeuritis multiplex produces painful, asymmetric involvement of multiple peripheral nerves.
- Small-fibre neuropathy may have normal routine nerve conduction studies.
- Reduced ankle reflexes support peripheral nerve dysfunction.
- Diabetes is an important cause of acquired distal symmetric neuropathy.
- GBS requires urgent monitoring for respiratory failure and autonomic dysfunction.
- CIDP may respond to corticosteroids, IVIG or plasma exchange.
- CMT usually causes slowly progressive distal weakness with foot deformity.
- Nerve conduction studies classify the physiological pattern; genetic testing may confirm inherited disease.
- Neuropathic pain management, foot protection, rehabilitation and orthoses reduce complications and disability.
5. Clinical Memory Hooks
Clinical Hook 1 — Diabetic Neuropathy
Long-standing diabetes with bilateral burning feet and absent ankle reflexes → distal symmetric polyneuropathy.
Clinical Hook 2 — Acute Immune Neuropathy
Ascending weakness after infection with areflexia → suspect GBS and assess respiratory function urgently.
Clinical Hook 3 — Hereditary Neuropathy
Childhood foot drop, pes cavus, distal wasting and affected relatives → suspect Charcot–Marie–Tooth disease.
Clinical Hook 4 — Vasculitic Neuropathy
Painful, stepwise deficits affecting separate nerve territories → mononeuritis multiplex; consider vasculitis.
6. Starred High-Yield Exam Points
Priority KMU Concepts
⭐ 1. Reduced nerve conduction amplitudes favour axonal loss; marked conduction slowing favours demyelination.
⭐ 2. Rapid progressive weakness with areflexia suggests GBS; respiratory and autonomic deterioration are major dangers.
⭐ 3. Albuminocytologic dissociation supports GBS, but normal early CSF does not exclude it.
⭐ 4. IVIG or plasma exchange treats typical GBS when indicated; corticosteroids alone are ineffective.
⭐ 5. CMT1 is predominantly demyelinating; CMT2 is predominantly axonal. PMP22 duplication classically causes CMT1A.
⭐ 6. A positive family history supports hereditary neuropathy, but its absence does not exclude an inherited cause.