Mononeuritis multiplex Health Article

Definition

Mononeuritis multiplex is a brain/nervous system (neurological) disorder that involves damage to at least two separate nerve areas.

Alternative Names

Mononeuropathy multiplex; Multifocal neuropathy

Causes, incidence, and risk factors

Mononeuritis multiplex is a form of damage to nerves outside the brain and spinal cord (peripheral neuropathy). It is a group of symptoms, not a disease. A part of the nerve cell called the axon is destroyed, which interferes with nerve signaling.

The cause of mononeuritis multiplex affects nerves in many areas. As the disorder gets worse, the damage may become more widespread and affect more nerves. Common causes include:

• A lack of oxygen from decreased blood flow
• Swelling and irritation (inflammation) of blood vessels

No cause is found in about a third of cases.

Common causes of mononeuritis multiplex include:

• Blood vessel diseases such as polyarteritis nodosa
• Connective tissue diseases such as rheumatoid arthritis or systemic lupus erythematosus
• Diabetes mellitus

Connective tissue disease is the most common cause of mononeuritis multiplex in children.

Less common causes include:

• Amyloidosis
• Disorders of the blood (such as hypereosinophilia and cryoglobulinemia)
• Infections such as Lyme disease
• Leprosy
• Sarcoidosis
• Sjogren syndrome
• Wegener's granulomatosis

Symptoms

• Abnormal sensation
• Burning pain
• Difficulty moving a part of the body (paralysis)
• Inability to move a part of the body
• Lack of control over movement in a part of the body
• Lack of or decreased sensation in any part of the body
• Numbness and tingling

Specific symptoms depend on the nerve involved.

Signs and tests

A detailed history is needed to determine the possible cause of the disorder. Examination and neuromuscular testing may show a loss of feeling and movement due to problems with specific nerves. Reflexes may be abnormal.

To diagnose mononeuritis multiplex usually requires problems with two or more unrelated nerve areas. Common findings may include the following:

• Axillary nerve dysfunction
• Common peroneal nerve dysfunction
• Distal median nerve dysfunction
• Femoral nerve dysfunction
• Radial nerve dysfunction
• Sciatic nerve dysfunction
• Ulnar nerve dysfunction

Tests that may be done include:

• EMG
• Nerve biopsy
• Nerve conduction velocity

Other possible tests include:

• Antinuclear antibody panel
• Blood tests
• C-reactive protein
• Imaging tests
• Lyme disease antibody
• Rheumatoid factor
• X-rays