Update on classification, epidemiology, clinical phenotype and imaging of the nonsystemic vasculitic neuropathies

Michael P. Collins, P. James B. Dyck, Robert D.M. Hadden

Research output: Contribution to journalReview article

2 Scopus citations

Abstract

Purpose of reviewSingle-organ vasculitis of the peripheral nervous system (PNS) is often designated nonsystemic vasculitic neuropathy (NSVN). Several variants or subtypes have been distinguished, including migratory sensory neuropathy, postsurgical inflammatory neuropathy, diabetic radiculoplexus neuropathies, skin-nerve vasculitides, and, arguably, neuralgic amyotrophy. NSVN often presents as nondiabetic lumbosacral radiculoplexus neuropathy (LRPN). This review updates classification, clinical features, epidemiology, and imaging of these disorders.Recent findingsA recent study showed the annual incidence of LRPN in Olmstead County, Minnesota to be 4.16/100000:2.79/100000 diabetic and 1.27/100000 nondiabetic. This study was the first to determine the incidence or prevalence of any vasculitic neuropathy. In NSVN, ultrasonography shows multifocal enlargement of proximal and distal nerves. In neuralgic amyotrophy, MRI and ultrasound reveal multifocal enlargements and focal constrictions in nerves derived from the brachial plexus. Histopathology of these chronic lesions shows inflammation and rare vasculitis. Diffusion tensor imaging of tibial nerves in NSVN revealed decreased fractional anisotropy in one study.SummarySingle-organ PNS vasculitides are the most common inflammatory neuropathies. Neuralgic amyotrophy might result from PNS vasculitis, but further study is necessary. The usefulness of focal nerve enlargements or constrictions in understanding pathological mechanisms, directing biopsies, and monitoring disease activity in NSVN should be further investigated.

Original languageEnglish (US)
Pages (from-to)684-695
Number of pages12
JournalCurrent opinion in neurology
Volume32
Issue number5
DOIs
StatePublished - Oct 1 2019

Keywords

  • epidemiology
  • lumbosacral radiculoplexus neuropathy
  • neuralgic amyotrophy
  • peripheral neuropathy
  • ultrasonography
  • vasculitis

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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