Mononeuritis Multiplex - Symptoms, Diagnosis, Treatment

Definition:

Mononeuritis multiplex is an excruciating, uneven, asynchronous motor and sensory peripheral neuropathy that involves separate damage to at least two nerve areas. It is also known as multifocal neuropathy or mononeuropathy multiplex. It is a kind of Peripheral neuropathy in which multiple nerves are affected asymmetrically and multifocal, also results to cause weakness or typical numbness. Mononeuritis multiplex is abbreviated as (MNM).

Mononeuritix multiplex is an asynchronous motor and sensory peripheral neuropathy which is very painful. Numerous nerves in random areas of the body are supposed to be affected. The syndromes of Mononeuritix multiplex can be distributed bilaterally, distally and also proximally through whole of the body. Mononeuritis multiplex causes a loss of function in tissues of muscles. Mononeuritis multiplex is not only a form of damage of nerves, it is a disorder the brain and spinal cord but it is not due to single disease which means it is a group of different disease and symptoms so it is a syndrome.

For example:

A sudden loss of the ability of the foot to lift up while walking which is called as foot drop condition can be caused by Mononeuritis multiplex.

Causes:

In Mononeuritis multiplex group of distinct disorders includes following types of diseases

·         Amyloidosis  

·         Diabetes mellitus

·         Blood vessel dieases such as polyartheritis nodosa

·         Leprosy

·         Many connective tissue diseases such as systemic lupus and rheumatoid arthritis

·         Blood disorders like cryoglobulinemia and hypereosinophilia

·         Paraneuplastic syndrome

·         sarcoidosis

·         direct tumors

·         vasculitus

and many other disease can the cause of the Mononeuritis multiplex  such as infection like hepatitis C , hepatitis B, acute viral hepatitis A, herpes simplex virus infection, HIV and AIDS. The damage of nerves involves the destruction of axons the most common cause of this damage is the loss of oxygen supply to such areas which causes decrease in blood flow and also causes destruction vessel walls resulting in inflammation of blood vessels.

 Symptoms:

Following are the symptoms of the Mononeuritis multiplex are as follow basically their symptoms are depended accordingly to the specific nerves which are involved in the injury and here are those symptoms.

·         Loss of sensations in one or more areas of the body resulting numbness and weakness of the muscles 

·         Paralysis in those areas where the nerves are damaged and it can be at one area or more.

·         Weakness in the affected area it also can be one or more

·         Loss of locomotion of that area from where the nerve is affected for example loses of hand movement, finger movements or leg movements.

·         Loss of the sensation in one or more affected area of the body.

·         Intense pain when try to move the affected parts of the body.

·         Tingling, burning, pain or other abnormal sensations in one or more areas of the body.

·         Loss of the bladder functioning and control.

·         Loss of the bowel control and functioning as well these all are the symptoms of the Mononeuritis multiplex syndrome.

Diagnosis:

For the diagnosis of the Mononeuritis multiplex can be suspected from a clinical history. It is really easy to detect that does the patient is suffering from Mononeuritis multiplex or not.

Typically Mononeuritis multiplex causes painful sensations, acute or sub acute motor and sensory deficits that is not limited to none nerve, it can be multifocal. Patient will normally complains to have pain in the movement of the affected muscles in an overlapping pattern. If any of the nerve is affected so initially there will be only the involvement of one of the branches of the nerve latterly it will increase like for example it the targeted affected nerve is sciatic nerve so initially its few branches will get effects and cause a specific pain due to this nerve called as “sciatica”. Or pertients without pain sensations, with proximal greater than distal weakness with purely involvement of motor reflexes so the patient is likely to have a vasculitic neuropathy this is clear cut explanation because most of the time people confuse mononeurits multiplex with this neuropathy.

Diagnosis normally involves following ways like physical examinations which includes eye examinations, neck and face examinations, pulmonary examinations and abdominal and genital inspections. If symptoms match with the symptoms of (MNM) so the syndrome will be diagnosed.

For initial examinations laboratory studies are involved like :

·         LFT’s .FBC , urine analysis blood glucose test etc.

·         chest CT scans and CXR.

·         Inflammation markers tests.

·         Auto antibodies association test with systemic vasculitis and serology for hepatitis B, hepatitis C and HIV ad AIDS.

·         Electrediagnostic (EMG) studies

·         Muscle biopsy.

·         Peripheral nerve or nerve bio.

Later tests involves many test like skin biopsy, PET scans if CT scan results are not positive. PAT and MR angiography are also known as last diagnostic tests.

Treatment:

The treatment of mononuritis multiplex includes numbers of different surgeries plus including many heavy medications if this succeeds than doctors can proceed fatherly to the therapies like vocational therapies, physical therapies to those areas where nerves were affected in past, physiological treatments it which physiologist can help patient to think positive and restart his or her life’s routine in a normal pattern. Occupational therapies are also a good way of to treat the patient. All the medical staff is supposed to treat the illness from where that illness is come from. Doctors should feel themselves free to treat (MNM) as we all know very well that this disease it very harmful and affective for the patient as it effects the axons and neurons (which are the function cell of the brains).

Medication which should be given to the patients to relive and counter pain medicines are (ibuprofen or acetaminophen) or prescription pain medications may be needed to control pain (neuralgia).

Anticonvulsants (gabapentin, phenytoin, carbamazepine, or pregabalin) or antidepressants (amitriptyline, nortriptyline, or duloxetine), may be used to reduce stabbing pains.

Also patient should be treated with proper system of hygiene’s so that the patient will not get further more infections.