Mononeuritis Multiplex

Type of peripheral neuropathy which is characterized by simultaneous or sequential involvement of individual non-contiguous nerve trunks, either partially or completely, evolving over days to years and typically presenting with acute or subacute loss of sensory and motor function of individual nerves

Aetiology

• Diabetes mellitus

• Leprosy

• Vasculitis, including eosinophilic granulomatosis with polyangiitis amyloidosis (most common cause)

• Malignancy

• Neurofibromatosis

• HIV and hepatitis C infection

• Multifocal motor neuropathy with conduction block

Clinical presentation

• The pattern of involvement is asymmetric

• However, as the disease progresses, deficits becomes more confluent and symmetrical, making it difficult to differentiate from polyneuropathy

• Therefore, attention to the pattern of early symptoms is important

• Mononeuritis multiplex may also cause pain, which is characterized as deep, aching pain that is worse at night and frequently in the lower back, hip, or leg

• In people with diabetes mellitus, mononeuritis multiplex is typically encountered as acute, unilateral, and severe thigh pain followed by anterior muscle weakness and loss of knee reflex

Management

• Depends on aetiology