Mononeuritis Multiplex Misdiagnosed as Multiple Lumbosacral Radiculopathies

Abstract

We report a case involving a 71-year-old female patient with rheumatoid arthritis who presented with severe back pain, symmetrical distal lower limb pain and sensory abnormalities in her distal lower limbs for 2 months. Electrodiagnosis was performed and then diagnosed as multiple lumbosacral radiculopathies and peripheral polyneuropathy. After about 2 weeks, motor weakness and sensory loss in the lower extremities worsened. Mononeuritis multiplex was diagnosed on a follow up electrodiagnosis. Thereafter, the patient was transferred to rheumatology department for treatment. Steroid pulse therapy was attempted, however, due to complication after the first session, the treatment was not completed. After 10 months, there has been no change in the patient symptoms of distal limb weakness and sensory loss. This is a case of mononeuritis multiplex that was misdiagnosed multiple lumbosacral radiculopathies in a patient with rheumatoid arthritis.