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Peripheral neuropathic syndromes in giant cell (temporal) arteritis
R J Caselli1, J R Daube, G G Hunder
1Department of Neurology, Mayo Clinic, Rochester, MN 55905.
Neurology
|May 1, 1988
Summary
Giant cell arteritis (GCA) can cause peripheral neuropathic syndromes in 14% of patients. Nerve conduction studies confirmed abnormalities in all affected individuals, highlighting a significant neurological complication of GCA.
Area of Science:
- Neurology
- Rheumatology
- Vascular Medicine
Background:
- Giant cell arteritis (GCA), also known as temporal arteritis, is a systemic vasculitis primarily affecting medium and large arteries.
- Peripheral neuropathic syndromes are potential but less commonly recognized manifestations of GCA.
Observation:
- This study investigated the incidence and characteristics of peripheral neuropathic syndromes in patients with histologically confirmed GCA.
- Among 166 consecutive GCA patients over three years, 23 (14%) presented with clinically diagnosed peripheral neuropathic syndromes concurrent with active GCA.
Findings:
- Electromyography and nerve conduction studies in 16 patients confirmed neurological abnormalities.
- The spectrum of neuropathy included generalized peripheral neuropathy (11 patients), multiple mononeuropathies (9 patients), and mononeuropathy (3 patients).
- Affected nerves included median, ulnar, peroneal, tibial, sural nerves, and C-5 and L-5 nerve roots. Angiography revealed arteritis in lower limbs, with chronic changes noted in an amputation specimen post-treatment.
Implications:
- Peripheral neuropathic syndromes are a notable clinical feature in a significant subset of GCA patients.
- Early diagnosis and management of these neurological complications may be crucial for patient outcomes.
- Further research into the pathogenesis and optimal treatment strategies for GCA-associated neuropathies is warranted.