Vasculitic Neuropathies

Elie Naddaf, P. James B Dyck

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

From pathological standpoint, we divide vasculitic neuropathies in two categories: nerve large arteriole vasculitides and nerve microvasculitis. It is also important to determine whether a large arteriole vasculitis has an infectious etiology as it entails different treatment approach. Treatment of non-infectious large arteriole vasculitides consists initially of induction therapy with corticosteroids. Adding an immunosuppressant, mainly cyclophosphamide, is often needed. Treatment of infectious large arteriole vasculitides needs a multidisciplinary approach to target both the underlying infection and the vasculitis. Corticosteroids are the first-line therapy for classic non-systemic vasculitic neuropathy. Stable or improving patients without biopsy evidence of active vasculitis can be either observed or treated. Currently, adding an immunosuppressant is only indicated for patients who continue to progress on corticosteroids alone or patients with a rapidly progressive course. The treatment of the radiculoplexus neuropathies such as diabetic lumbosacral radiculoplexus neuropathy, lumbosacral radiculoplexus neuropathy (in non-diabetic patients), and diabetic cervical radiculoplexus neuropathy, as well as painless diabetic motor neuropathy, is not well established yet. We treat patients, if they present early on in the disease course or if they have severe disabling symptoms, with IV methylprednisolone 1 g once a week for 12 weeks.

Original languageEnglish (US)
Article number44
JournalCurrent Treatment Options in Neurology
Volume17
Issue number10
DOIs
StatePublished - Oct 13 2015

Keywords

  • Churg-Strauss syndrome
  • Cryoglobulinemia
  • Diabetic cervical radiculoplexus neuropathy
  • Diabetic lumbosacral radiculoplexus neuropathy
  • Hepatitis C vasculitic neuropathy
  • HIV-associated vasculitic neuropathy
  • Lumbosacral radiculoplexus neuropathy
  • Microscopic polyangiitis
  • Microvasculitis
  • Necrotizing vasculitis
  • Nerve large arteriole
  • Non-systemic vasculitic neuropathy
  • Painless diabetic motor neuropathy
  • Polyarteritis nodosa
  • Rheumatoid vasculitis
  • Sjögren’s syndrome
  • Vasculitic neuropathy
  • Wegener’s granulomatosis

ASJC Scopus subject areas

  • Clinical Neurology

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