Approach to Vasculitic Neuropathies

Abstract

Since vasculitic neuropathy is treatable and potentially debilitating, clinicians should develop an approach to neuropathy that increases the likelihood of uncovering existing systemic or nonsystemic vasculitis. The presence of a connective tissue disease, systemic vasculitis, asymmetric or non--length-dependent axonal polyneuropathy, or multiple axonal mononeuropathies should heighten suspicion, but vasculitic neuropathy can also present as a distal symmetric polyneuropathy with or without other organ involvement. Electrodiagnostic testing utilizing extensive nerve conductions may be helpful in identifying features suggestive of vasculitic neuropathy and in selecting an abnormal nerve and muscle for biopsy confirmation. An array of laboratory tests may lead to identification of a systemic disorder that is either characterized by or predisposes to vasculitic neuropathy. The mainstays of treatment are corticosteroids and cyclophosphamide, but other drugs are used in specific conditions. With early diagnosis and careful monitoring of treatment regimens, the prognosis is usually good.

Steroid Responsive Mononeuritis Multiplex in the Cronkhite–Canada Syndrome

“…Clinically, MM can present as asymmetrical, asynchronous sensory, and/or motor polyneuropathy involving two or more separate nerve in random patterns of distribution: bilaterally, distally, proximally, or combinations of these. Hence, it can also be termed as “multiple mononeuropathy,” and autoimmune, paraneneoplastic, and diabetic etiologies are often implicated (3, 4). Electrophysiologically, NCS often shows an axonal neuropathy whereby side-to-side comparison show grossly asymmetric amplitudes (5), as in this patient.…”

Assessment of Recovery From Burn-Related Neuropathy by Electrodiagnostic Testing

“…Additionally, there was a trend towards improvement, which would not be typical in mononeuritis multiplex associated with vasculitidies. [24]…”

Efficacy of physiotherapy in case of drop-foot developed due to vasculitic neuropathy

“…[8] Ortezler ve fizyoterapi nö-ropatik a¤r› tedavisi amac›yla da uygulanabilece¤i bildirilmifltir. [11] Hastam›za özel yap›lm›fl afo ile hastan›n yürüyüfl paternlerinde önemli düzelmeler gözlemlendi ve bu durumun pozisyon hissi ile ilgili mesajlar›n beyine do¤ru iletilmesini sa¤layarak proprioseptif duyunun ve dengenin geliflimine katk›da bulundu¤unu düflünmekteyiz.…”