Mononeuritis multiplex (MNM) is a disorder of the nervous system. It affects two areas of the nervous system and can result in severe pain, loss of motor ability, and loss of sensation in two random areas of the body. The areas that MNM affects will depend on the underlying cause of the condition.
MNM is caused by damage to two separate nerve areas outside the brain and spinal cord. This condition is a syndrome, which means it is a group of symptoms rather than a disease.
Several diseases can cause MNM. These include:
- polyarteritis nodosa
- diabetes millitus
- rheumatoid arthritis
- systemic lupus
Less common causes of MNM include:
- Sjogren syndrome
- Wegener’s syndrome
- Lyme disease
Your symptoms will vary depending on the type of nerves that are damaged, but they may include:
- weakness in one or more limbs
- loss of feeling in one or more areas of your body
- paralysis of part of your body
- tingling or discomfort in one or more areas of your body
To determine the specific cause of your MNM, your doctor will need to compile your medical history in detail. He or she will also need to perform examinations and tests on your neuromuscular system and your reflexes. Two unrelated nerve areas need to be affected for a diagnosis of MNM. Your doctor may recommend the following tests:
- nerve biopsy—a microscopic examination of a nerve
- electromyogram—a monitoring of muscular electrical activity
- nerve conduction tests—a measurement of the speed of nerve impulses
Additional tests may include:
- blood chemistry tests
- imaging scans
- rheumatoid factor test
- thyroid tests
- sedimentation rate
Treatment of MNM will depend on the disorder that is causing your condition. Therefore, your doctor will first need to determine that underlying condition.
A neuromuscular neurologist will develop your treatment plan. You will also have a consultation with a rheumatologist if you have any diseases that involve connective tissue such as arthritis.
The aims of the treatment are to:
- cure the illness that is the cause of the problem
- provide care and support to increase your independence
- control symptoms with medication or nutritional supplementation
Your doctor may suggest occupational therapy (OT) to help increase your mobility and independence. According to the American Occupational Therapy Association (AOTA), the goal of OT is to help people with a disability or recovering from an injury to regain the skills needed to pursue their daily activities or occupations (AOTA).
Your OT therapist will visit your home and/or work environment and suggest ways to accomplish activities safely. He or she may provide a plan of exercises to help you regain motor skills and strengthen muscles. Your OT therapist may suggest that you use adaptive equipment to make it easier to move through your house and keep you from falling. These items may include:
- a railing on steps
- a bath or shower seat
- adequate lighting
- a stair lift
You may benefit from orthopedic aids if you are having difficulty moving around in or outside your home. These include:
- a wheelchair
- corrective shoes
Your doctor may recommend physical therapy as part of your treatment plan. This involves using stretching and strengthening exercises and low-impact aerobics to strengthen your muscles, increase flexibility, and improve balance.
Vocational therapy (VT) is a valuable part of a structured treatment program. The aim of VT is to help you resume employment. It can help you cope with the changes in your physical and mental functioning. It can also help you find an occupation that is productive and matches your abilities.
Your doctor may prescribe medication to help manage the pain, including:
- antidepressants (for relief from stabbing pains)
A full recovery may be possible if the underlying cause can be diagnosed and treated successfully and damage is limited.
The extent of disability can range from none to a complete loss of movement or feeling.
Nerve pain can cause a great deal of discomfort and may be prolonged. You should see a pain specialist to discuss available treatment options if this is the case.
You may have injuries that will go unnoticed if you experience decreased sensation in your feet or any other part of your body. This is because the nerves in the affected area are not sending pain signals to your brain. The injuries may become severely infected if this happens. Inspect these areas regularly for bruises or cuts to prevent this from happening.
What Long-Term Complications Are Associated with Mononeuritis Multiplex? | Complications
A number of complications are related to MNM, including:
- loss of muscle mass or tissue
- kidney disease
- gastrointestinal disease
- pulmonary disease
- corticosteroid-induced diabetes