Mononeuropathy multiplex

Mononeuropathy multiplex (MM) is an infrequent complication that can occur in early HIV infection, because of dysimmune or vasculitic mechanisms (Gherardi et al. 1989 Chamonard et al. 1993 Bradley and Verma 1996 Schifitto et al. 1997 Mahadevan et al. 2001). Seroconversion-related MM has been described in a case report (Sngimoto et al. 2006). Most of these patients have a good prognosis as symptoms resolve spontaneously and treatment may not be necessary. In others, treatment has focused on intravenous immunoglobulin, judicious short-term use of steroids, and a combination of zidovudine and plasmapheresis (Chamouard et al. 1993 Cohen et al. 1993 Bradley and Verma 1996 Schifitto et al. 1997). 

Peripheral neuropathies maybe widely disseminated or focal. Patients with disseminated polyneuropathy, whether demyelinative or axonal, usually demonstrate distal sensory and/or motor impairment. Multifocal neuropathy, also referred to as mononeuropathy multiplex, is often a consequence of lesions affecting the vasa nervorum, the blood vessels that supply peripheral nerves. The most common diseases to compromise the vasa nervorum and cause infarction of nerve fascicles are diabetes mellitus and periarteritis nodosa. Other frequent causes of mononeuropathy multiplex include infection (e.g. Lyme disease and leprosy) and multiple compression injury (e.g. bilateral carpal tunnel syndrome). When mononeuropathy... 

The lepromatous form of leprosy is characterized by loss ofcutaneoussensibility. Hansen sbacillus(Mycobacterium leprae), which proliferates only in environments cooler than the core temperature maintained by most mammals, is capable of infecting Schwann cells in subcutaneous nerves because the basal lamina of these cells contains a-dystroglycan, to which this mycobacterium binds, and because subcutaneous nerves are often cooler than deeper tissues. Lepromatous neuropathy is a common cause of sensory mononeuropathy multiplex in the developing World [16,17]. 

Neuropathy in human immunodeficiency virus infection has many causes. Multiple mechanisms cause neuropathy in patients with HIV. An immune-mediated, Guillain-Barre-like syndrome (see below) may occur at the time of HIV seroconversion. Later in the course of infection, patients may present with mononeuropathy multiplex, sometimes as a consequence of vasculitis associated with coinfection with hepatitis C. Distal sensory-autonomic axonal polyneuropathy may develop in patients with more advanced HIV, either as a consequence of high titers of HIV itself or of the neurotoxicity of antiretroviral drugs [18,19],... 

Other rare forms of neuropathy (SED-13,1092) include mononeuropathy multiplex (52), acute axonal polyneuropathy (53), anterior ischemic optic neuropathy (54), trigeminal sensory neuropathy (55), bilateral neuralgic amyotrophy (56), brachial plexopathy (57), and symptoms suggestive of leukoencephalopathy (58). 

Maeda M, Ohkoshi N, Hisahara S, Mizusawa H, Shoji S. [Mononeuropathy multiplex in a patient receiving interferon alpha therapy for chronic hepatitis C.j Rinsho Shinkeigaku 1995 35(9) 1048-50. 

Blood eosinophilia > 10% Mononeuropathy (including multiplex) or pol3meuropathy Nonfixed pulmonary infiltrates on roentgenography Paranasal sinus abnormality Biopsy containing a blood vessel with extravascular eosinophils... 

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