Ischemic monomelic neuropathy: a rare complication after vascular access formation

Ischemic Monomelic Neuropathy: Diagnosis, Pathophysiology, and Management

“…According to one study that involved 19 cases, 10 patients were not improved even after correction of hemodialysis access. 10 However, even if surgical correction of the shunt is performed within a short time, symptoms may be only slightly or even not at all improved. Despite attempts at earlier closure, several published reports suggest that even with this aggressive management, IMN symptoms may be permanent or only partially reversible.…”

Ischemic Monomelic Neuropathy: A Long-Term follow-up of Two Cases

“…IMN is an under-appreciated and disabling complication of upper extremity hemodialysis access because of its variable manifestations in the postoperative period, and is difficult to diagnose with underlying comorbidities (1–4). The hemodynamic disturbance that occurs during the time of access creation can lead to both neurologic and ischemic complications.…”

“…The two patients reported here were both diabetics and received an upper-arm fistula. This complication occurs with the diversion of blood supply away from the forearm causing decreased perfusion to vasa nervorum leading to sensorimotor neurological complication (1–4). This can lead to both short- and long-term neurological sequels.…”

“…Ischemic monomelic neuropathy (IMN) consists of multiple axonal-loss mononeuropathies that develop acutely and simultaneously in the distal portion of the upper limb immediately after creating an arteriovenous access (1–4). It can present with global muscle pain, weakness or/and paresthesia.…”

Ischemic monomelic neuropathy (IMN) -A Case Report

“…median ,ulnar and radial )in the upper limb in IMN is not so common. [8] Long duration tourniquet or tight immobilization bandages cause ischemia leading to tissue hypoxia, hyperkalaemia and acidosis. High energy phosphate depletion results in loss of membrane potential of the ischemic myocytes due to failure of the sodium pump with leakage of potassium into the interstitium [9].…”