Mononeuritis Multiplex

Overview

Mononeuritis multiplex (MNM) describes disorders affecting ≥2 peripheral nerves in different, discrete regions occurring simultaneously or sequentially. Its involvement may initially be asymmetric but become symmetrical over time as more nerves are involved. This may make it difficult to distinguish MNM from polyneuropathy.

Causes

• Ischaemic:
  • Vasculitis – the most common cause of MNM
    • This can reduce blood flow to nerves.
  • Diabetic neuropathy
• Inflammatory causes:
  • Sarcoidosis
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Some variants of Guillain-Barré syndrome
  • Crohn’s disease, ulcerative colitis, coeliac disease
  • Graft-versus-host disease
• Infectious causes:
  • Lyme disease
  • Leprosy
  • HIV
  • Varicella zoster virus (VZV)
  • Cytomegalovirus (CMV)