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Nonvasculitic, steroid-responsive mononeuritis multiplex

E L Logigian1, J M Shefner, M P Frosch

  • 1Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.

Neurology
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

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Two patients experienced mononeuritis multiplex, a nerve disorder causing pain and weakness. Sural nerve biopsies revealed inflammation without identifiable causes, but steroids led to significant improvement.

Area of Science:

  • Neurology
  • Pathology

Background:

  • Mononeuritis multiplex presents as asymmetric, multifocal nerve damage.
  • Diagnosis often requires excluding infections, malignancy, and vasculitis.

Observation:

  • Two patients presented with sensory symptoms (pain, paresthesias) followed by motor weakness.
  • Sural nerve biopsies showed focal perineurial and endoneurial inflammation.
  • No vascular necrosis, lymphoid malignancy, or mycobacterial infection was found.

Findings:

  • Electrophysiology confirmed asymmetric sensorimotor axon loss radiculoneuropathy affecting limb and paraspinal muscles.
  • Elevated cerebrospinal fluid protein was noted in one patient.
  • No underlying systemic disease or identifiable cause was determined.

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Implications:

  • This suggests a distinct inflammatory neuropathy potentially responsive to immunosuppression.
  • Steroid therapy resulted in marked clinical improvement.
  • Further research is needed to elucidate the pathogenesis and identify specific triggers.