NEUROPATI

Endang Mutiawati

• ANATOMI- Sel neuron- Akson- Dendrit- sel schwan

• Nervus kranialis I-XII• Nervus spinalis :– Servikalis– Torakalis– Lumbalis– Sakralis(pleksus brachialis, pleksus

lumbalis, pleksus sakralis

Neuropati

• Gangguan saraf tepi (motorik, sensorik & otonom)

• Bentuk2 neuropati :– Mononeuropati– Mononeuritis multipel– Radikuloneuropati– Poliradikulitis– Pleksitis– polineuritis

Mononeuropati• Yg terkena hanya 1 saraf

tepi• Penyebab– Trauma– Diabetes melitus– Poliarteritis nodusa

Mononeuritis multipel• Yg terkena bbrp saraf tepi• Penybb sama dgn mono

neuropati

Radikulopati Yg terkena radik spinalis Pnybb :◦ HNP◦ tumor

Poliradikulopati• Yg terkena : bbrp radik

n. spinalis• Pnybb : – Pasca infeksi– Pasca vaksinasi

Pleksitis• Inflamasi pleksus• Pl. brakhialis, lumbalis &

sakralis

Polineuritis- Simetris neuropati- Pnybb :

- DM, alkoholik,

Patologi

• Perubahan pd akson– Degenerasi akson (wallerian degenerasi)– Distrofi akson

• Perubahan pd mielin– segmental demielinisasi

Motorik• Lemah lumpuh• Atrofi• Fasikulasi• Refleks menurun (-)

Sensorik• Disestesia• Parastesia

Otonom• Keringan (-)• Ggn VU• Konstipasi• impotensia

Jenis neuropati (lokasi)

• Neuropati nn. Krianialis• Neuropati pleksus servikalis• Neuropati pleksus lumbalis• Neuropati pleksus sakralis• Neuropati herediter

Neuropati nn. Kranialis

• III, IV, VI• V (neuralgia trigeminal = Tic Douloreux)• VII (Bell’s Palsy), hemifasial spasme• VIII• IX (glossopharingeal neuralgia), • X (superior laryngeal neuralgia), • XI,• XII

Neuropati pleksus servikalis

• Neuralgia oksipitalis• Lesi n. phrenikus

Neuropati pleksus brakhialis• Birth injuries brachial plexus ( erb paralisis, klumpke

paralisis)• Trumatic injury• Brachial neuritis• Neoplastic involvement• Radiation damage• Individual neuropatic – Long thoracic n., suprascapula n., musculocutaneous

nerve, axillary n., radial n., posterior interosseus n., ulnar nerve, medianus n, Carpal tunnel synd. causalgia

Pleksus lumbalis

• Iliohypogastric nerve• Ilioinguinal nerve• Genitofemoral nerve• Lateral kutaneus nerve• Obturator nerve• Femoral nerve

Pleksus sakralis

• Superior gluteal nerve• Inferior gluteal nerve• Posterior cutaneus nerve• Pudendal nerve• Sciatic nerve• Peronel nerve (deep & superfisial)• Tibial nerve• Plantar & interdigital nerve

Hereditary Neuropathies

• Peroneal muscular atrophy• Chronic intersititial hypertropic neuropathy• other

Inflammatory neuropathies

• Herpes zoster• Diphtheria• Infectious mononucleosis• Postinfections polyneuritis (SGB)• Chronic inflammatory polyradiculopathy

Neuropati lainnya

• Neuropathies in vascular disease• Toxic neuropathy• Paraneoplastic neuropathies– Carsinomatous peripheral neuropathy– Critical illness polyneuropathies

• Nutrisional neuropathies– Beriberi (thiamin) neuropathy– Neuralgia in pregnancy