Multiple mononeuropathies are characterized by sensory disturbances and weakness in the distribution of ≥ 2 affected peripheral nerves.
(See also Overview of Peripheral Nervous System Disorders.)
Multiple mononeuropathy is usually secondary to
Systemic rheumatic diseases (eg, polyarteritis nodosa, systemic lupus erythematosus [SLE], other types of vasculitis, Sjögren syndrome, rheumatoid arthritis [RA])
Metabolic disorders (eg, diabetes, amyloidosis)
Infectious disorders (eg, Lyme disease, HIV infection, leprosy)
However, diabetes usually causes sensorimotor distal polyneuropathy.
Multiple mononeuropathies are characterized by pain, weakness, and paresthesias in the distribution of the affected nerves. Pure motor nerve involvement begins with painless weakness; pure sensory nerve involvement begins with sensory disturbances and no weakness. Multiple mononeuropathy is often asymmetric at first; nerves may be involved all at once or progressively. Extensive involvement of many nerves may simulate polyneuropathy.
Symptoms and examination findings may be nearly pathognomonic for multiple mononeuropathy. When they are not, electrodiagnostic testing is done to establish the diagnosis, localize the lesion, assess severity, and estimate prognosis.
Underlying disorders are treated.
