ABSTRACT
BACKGROUND: Mononeuropathy multiplex is a rare complication during the course of chronic he-patitis B, despite various neuropathies following acute hepatitis B having been reported previously. CASE REPORT: A 30-year-old man presented with sensorimotor symptoms in multiple peripheral nerves. The serological tests for hepatitis were consistent with chronic active hepatitis B. After treatment with oral prednisone combined with an antiviral agent, the sensory and motor symptoms improved and hepatitis B virus replication was reduced. CONCLUSIONS: We suggest that chronic immune-mediated neuropathy associated with hepatitis B virus infection should be considered in the differential diagnosis of patients with hepatitis B.
Subject(s)
Adult , Humans , Diagnosis, Differential , Hepatitis , Hepatitis B , Hepatitis B virus , Hepatitis B, Chronic , Hepatitis, Chronic , Mononeuropathies , Peripheral Nerves , Prednisone , Serologic TestsABSTRACT
BACKGROUND: It is important to consider leprosy as a cause of peripheral neuropathy, as it is readily treatable. We analyzed clinical and electrodiagnostic characteristics of leprosy patients with peripheral nerve involvement. METHODS: This study was a retrospective analysis of nerve conduction studies (NCS) and the medical records of 10 patients with leprosy were confirmed by a skin or nerve biopsy. NCS using a conventional surface technique were performed in 15 upper extremities and 14 lower extremities. RESULTS: Among ten patients, three patients presented with mononeuropathy, and the others with mononeuropathy multiplex. Five patients had medical histories of leprosy treatment. The patterns of peripheral neuropathies were mononeuropathy multiplex except for one who had an ulnar mononeuropathy. On motor NCS, low or absent CMAPs were most common abnormalities followed by slow conduction velocity and prolonged terminal latency. Sensory NCS also showed changes of amplitudes rather than in conduction velocity. The conduction block of CMAPs with or without dispersion were observed in 5 patients usually on the ulnar nerve at the forearm. CONCLUSIONS: In most instances, leprous patients with neuropathy presented with mononeuropathy multiplex affecting the sensory and motor nerves. NCS showed more likely axonal than demyelinating changes, but the conduction blocks were also found frequently at the forearms.
Subject(s)
Humans , Axons , Biopsy , Forearm , Leprosy , Lower Extremity , Medical Records , Mononeuropathies , Neural Conduction , Peripheral Nerves , Peripheral Nervous System Diseases , Retrospective Studies , Skin , Ulnar Nerve , Upper ExtremityABSTRACT
Neurolymphomatosis, which is defined as a peripheral nerve infiltration of lymphoma, is an infrequent complication of systemic lymphoma and the isolated involvement of the peripheral nerve as a sign of recurrence is very rare. Here, we report a case with neurolymphomatosis presented as a mononeuropathy multiplex and is the first reported case in Korea. With potent chemotherapy, the blood-nerve barrier may have a critical role in the isolated recurrence of lymphoma in the peripheral nervous system.
Subject(s)
Animals , Blood-Nerve Barrier , Drug Therapy , Korea , Lymphoma , Lymphoma, B-Cell , Marek Disease , Mononeuropathies , Peripheral Nerves , Peripheral Nervous System , RecurrenceABSTRACT
A 31-year-old woman had a livedo reticularis of reticulated, bluish discoloration on both arms and legs for 18 months with a burning pain in the right hand and numbness in both lower legs. The findings of the electromyography were consistent with mononeuropathy multiplex and bilateral ulnar-median nerve anastomosis. A biopsy specimen from the right sural nerve showed perivascular lymphocytic infiltration and occasional myelin digestion chambers, which were consistent with vasculitic neuropathy. We present a patient with livedo reticularis idiopathica associated with mononeuropathy multiplex syndrome who also has bilateral ulnar-median nerve anastomosis.