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Multiple Mononeuropathy

(Mononeuritis Multiplex)

by Michael Rubin, MDCM

Multiple mononeuropathies are characterized by sensory disturbances and weakness in the distribution of the affected nerve or nerves.

Multiple mononeuropathy is usually secondary to connective tissue disorders (eg, polyarteritis nodosa, SLE, other types of vasculitis, Sjögren syndrome, RA), sarcoidosis, metabolic disorders (eg, diabetes, amyloidosis), or infectious disorders (eg, Lyme disease, HIV infection, leprosy). However, diabetes usually causes sensorimotor distal polyneuropathy.

Multiple mononeuropathies are characterized by pain, weakness, and paresthesias in the distribution of the affected nerve or nerves. Pure motor nerve involvement begins with painless weakness; pure sensory nerve involvement begins with sensory disturbances and no weakness. Multiple mononeuropathy is often asymmetric at first; nerves may be involved all at once or progressively. Extensive involvement of many nerves may simulate polyneuropathy.

Symptoms and examination findings may be nearly pathognomonic. When they are not, electrodiagnostic testing is done to establish the diagnosis, localize the lesion, assess severity, and estimate prognosis.

Underlying disorders are treated.

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