Type of peripheral neuropathy which is characterized by simultaneous or sequential involvement of individual non-contiguous nerve trunks, either partially or completely, evolving over days to years and typically presenting with acute or subacute loss of sensory and motor function of individual nerves

Aetiology

It is caused by, or associated with, several medical conditions, including:

• Diabetes mellitus
• Leprosy
• Vasculitis, including eosinophilic granulomatosis with polyangiitis amyloidosis (most common cause)
• Malignancy
• Neurofibromatosis
• HIV and hepatitis C infection
• Multifocal motor neuropathy with conduction block

Clinical features

• The pattern of involvement is asymmetric
• However, as the disease progresses, deficits becomes more confluent and symmetrical, making it difficult to differentiate from polyneuropathy
• Therefore, attention to the pattern of early symptoms is important
• Mononeuritis multiplex may also cause pain, which is characterized as deep, aching pain that is worse at night and frequently in the lower back, hip, or leg
• In people with diabetes mellitus, mononeuritis multiplex is typically encountered as acute, unilateral, and severe thigh pain followed by anterior muscle weakness and loss of knee reflex

Management

• Depends on aetiology