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"Pseudo-conduction block" in vasculitic neuropathy
L McCluskey1, D Feinberg, C Cantor
1Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Muscle & Nerve
|September 17, 1999
Summary
Vasculitic mononeuropathy multiplex primarily causes axonal loss. Apparent conduction block in this condition is often due to temporary axonal injury, not true block, requiring careful electrophysiologic diagnosis.
Area of Science:
- Neurology
- Electrophysiology
- Pathology
Background:
- Vasculitic mononeuropathy multiplex is characterized by axonal loss.
- Electrophysiologic findings suggestive of conduction block have been reported in vasculitis-associated neuropathy.
Observation:
- Three patients with biopsy-proven vasculitis and mononeuropathy multiplex were studied.
- Eight nerves initially met criteria for conduction block.
Findings:
- Serial electrophysiologic studies revealed conversion to findings consistent with severe axonal loss.
- "Conduction block" in this context is attributed to focal axonal conduction failure from infarctive injury.
Implications:
- The term "conduction block" should be used cautiously in vasculitic mononeuropathy multiplex.
- Serial electrophysiologic studies are crucial for accurate diagnosis, distinguishing true block from axonal injury.