Acute Painful Sensory Neuropathy Diagnosed as Nonsystemic Vasculitic Neuropathy

Nonsystemic vasculitic neuropathy (NSVN) is a localized vasculitis confined to the peripheral nerves. Absence of systemic manifestations frequently leads to mis- or under diagnosis without the aid of pathologic study. NSVN may present typically with multiple mononeuropathies or less commonly with a sensorimotor polyneuropathy. We report two cases of NSVN presenting with acute severe painful neuropathy. Sural nerve pathology showed unequivocal vasculitis. High dose corticosteroid therapy was effective in controlling the pain. NSVN should be considered as a treatable cause of acute painful neuropathy.