Pronator Teres Syndrome Associated with Mononeuritis Multiplex in Polyarteritis Nodosa

Area of Science:

• Neurology
• Rheumatology
• Vascular Medicine

Background:

• Pronator teres syndrome involves median nerve compression at the elbow.
• Mononeuritis multiplex is a neurological complication characterized by damage to multiple individual peripheral nerves.
• Polyarteritis nodosa is a systemic vasculitis affecting medium-sized arteries.

Purpose of the Study:

• To report a rare case of pronator teres syndrome co-occurring with mononeuritis multiplex in a patient with polyarteritis nodosa.
• To describe the diagnostic and therapeutic approach for this complex presentation.

Main Methods:

• Clinical case presentation.
• Diagnostic workup including neurological examination and potentially imaging.
• Treatment involved surgical external neurolysis of the median nerve and pharmacotherapy with prednisolone.

Main Results:

• The patient presented with symptoms consistent with pronator teres syndrome and mononeuritis multiplex.
• External neurolysis of the median nerve in the proximal forearm provided relief.
• Systemic treatment with prednisolone was effective in managing the underlying polyarteritis nodosa and associated neuropathy.

Conclusions:

• Pronator teres syndrome can be a manifestation of mononeuritis multiplex in polyarteritis nodosa.
• A combined approach of surgical decompression and immunosuppressive therapy can be successful in treating this condition.