Mononeuritis multiplex is a brain/nervous system (neurological) disorder that involves damage to at least two separate nerve areas.
Mononeuritis multiplex is a form of damage to nerves outside the brain and spinal cord (peripheral neuropathy). It is a group of symptoms, not a disease. A part of the nerve cell called the axon is destroyed, which interferes with nerve signaling.
The cause of mononeuritis multiplex affects nerves in many areas. As the disorder gets worse, the damage may become more widespread and affect more nerves. Common causes include:
No cause is found in about a third of cases.
Common causes of mononeuritis multiplex include:
Connective tissue disease is the most common cause of mononeuritis multiplex in children.
Less common causes include:
Specific symptoms depend on the nerve involved.
A detailed history is needed to determine the possible cause of the disorder. Examination and neuromuscular testing may show a loss of feeling and movement due to problems with specific nerves. Reflexes may be abnormal.
To diagnose mononeuritis multiplex usually requires problems with two or more unrelated nerve areas. Common findings may include the following:
Tests that may be done include:
Other possible tests include:
The goals of treatment are to:
To improve independence, treatments may include:
Safety is an important consideration for people with sensation or movement difficulties. Lack of muscle control and decreased sensation may increase the risk of falls or injuries. Safety measures for people with movement difficulty may include:
Check shoes often for grit or rough spots that may injure the feet.
People with decreased sensation should check their feet (or other affected area) often for bruises, open skin areas, or other injuries that may go unnoticed. These injuries may become severely infected because the pain nerves of the area are not signalling the injury.
People with mononeuropathy multiplex are prone to new nerve injuries at pressure points such as knees and elbows. They should avoid putting pressure on these areas, for example by not leaning on the elbows, crossing the knees, or holding similar positions.
Over-the-counter analgesics or prescription pain medications may be needed to control pain (neuralgia). Other medications, including anticonvulsants (gabapentin, phenytoin, carbamazepine) or tricyclic antidepressants, may be used to reduce the stabbing pains that some people experience. Whenever possible, avoid or minimize the use of medications to reduce the risk of side effects.
Positioning (the use of frames to keep bedclothes off of a tender body part) and other measures may help control pain. Autonomic symptoms can be difficult to treat or respond poorly to treatment.
If the cause can be found and successfully treated, and if damage is limited, a full recovery is possible. The amount of disability can range from no disability, to partial or complete loss of movement, function, or sensation.
Nerve pain may be quite uncomfortable and can last for a long time. If this occurs, see a pain specialist to ensure that all pain treatment options are available to you.
Call your health care provider if you notice signs of mononeuritis multiplex.
Prevention techniques vary depending on the specific disorder. Proper diet and use of medication for diabetes may help prevent neuropathy from developing.
Mononeuropathy multiplex; Multifocal neuropathy