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Neurologic manifestations of Polyarteritis Nodosa
What are the neurologic manifestations of Polyarteritis Nodosa?
Half of patients diagnosed with PAN have evidence of peripheral neuropathy.
The five following peripheral neuropathy syndromes have been identified:
(1) mononeuritis multiplex of sensory and motor nerves;
(2) extensive mononeuritis multiplex with severe, primarily distal weakness and sensory deficits;
(3) isolated small cutaneous sensory nerve involvement;
(4) distal symmetric sensorimotor neuropathy;
(5) radiculopathy.
Myalgias have also been reported in 25% of patients with PAN, usually associated with weakness.
Peripheral neuropathy is a common and early finding of PAN.
CNS manifestations of vasculitic disease can be found in 40% to 45% of patients with PAN, including encephalopathy, seizures (40%), and focal deficits related to infarction (50%). Cranial nerve palsies occur in 15% of patients, most commonly involving cranial nerves II, III, and VIII.
Hypertensive CNS changes with papilledema and focal hemorrhages are observed in 10% of patients with an acute confusional state, and often signify a poorer prognosis.
CNS sequelae are often late manifestations of this disease, occurring 2 to 3 years after the initial diagnosis.
Sources
- Akil M, Amos RS: ABC of rheumatology. Rheumatoid arthritis: clinical features and diagnosis. Brit Med J 310:587-590, 1995.
- Siva A, Fresko II: Behçet’s disease. Curr Treat Options Neurol 2:435-448, 2000.
