by Carlo Raj, MD

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      Slides 06 MononeuritisMultiplex Neuropathology II.pdf
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    00:01 Here, we’ll take a look at mononeuritis multiplex.

    00:05 As the name implies, we have one nerve that is undergoing neuropathy or inflammation in multiple, multiple systems, is the topic for this section.

    00:17 Possible etiologies: Trauma, compression, diabetes, or vasculitides with or without connective tissue disease or infection related.

    00:30 Maybe it’s hepatitis B virus, HIV, hepatitis C virus.

    00:34 And one that you should know quite well is that polyarteritis nodosa may also present with mononeuritis multiplex.

    00:45 Other causes including leprosy, Lyme’s disease, sarcoidosis, or hereditary neuropathy with liability to pressure palsies, all possible causes of one nerve being affected in multiple locations.

    01:01 Let’s have a view on the clinical presentation of mononeuritis multiplex. This is a patterned involvement of a single nerve at multiple sites. This could be sequential or simultaneous. This is in contrast to polyneuropathy. Its clinical presentation shows involvement of multiple nerves at the site. For a diagnostic workup you use EMG and nerve conduction velocity tests to confirm neuropathy. Besides this you should use an etiology-specific diagnostic workup based on other associated symptoms to identify the cause.The treatment depends on the identification of the etiology. For instance, immunomodulation therapy for necrotizing vasculitides as a cause of mononeuritis multiplex is associated with significant motor and sensory improvement. Anti-convulsants can be used to help with neuropathic pain. Corticosteroids are helpful in some cases.

    01:57 In summary: Risk factors: Diabetes, family history.

    02:02 Preventative medicine: Well, good control of blood sugar if you’re suspecting diabetes because there’s every possibility that you have many nerves that might be affected.

    02:10 Signs and symptoms: Well, it depends on which nerve has been affected.

    02:15 For example, if it’s a nerve down in the leg, then it’s common peroneal.

    02:18 You might have – A patient experiences foot drop or maybe it’s radial nerve also being affected.

    02:27 So therefore, there’s wrist drop, same patient, multiple nerves -- – or excuse me, multiple locations.

    02:34 One nerve in each location being affected.

    02:37 Diagnostic workup: EMG, electromyogram, appropriate labs.

    02:43 And treatment here would be, well, etiology-specific.

    About the Lecture

    The lecture Mononeuropathy by Carlo Raj, MD is from the course Other Diseases: Hydrocephalus, Neuromuscular Disease, Plexopathy and Mononeuritis.

    Included Quiz Questions

    1. Common peroneal nerve
    2. Femoral nerve
    3. Superior gluteal nerve
    4. Inferior gluteal nerve
    5. Obturator nerve
    1. Electromyography
    2. Electrocardiography
    3. Magnetic resonance imaging
    4. Compute tomography scan
    5. Electroencephalography

    Author of lecture Mononeuropathy

     Carlo Raj, MD

    Carlo Raj, MD

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    Bullet point!!!!!
    By James A. on 30. May 2018 for Mononeuropathy

    Dr. Raj is quite interesting during lectures he makes information easy to integrate and remember it. Thank you, Dr. Raj.