Types of Peripheral Neuropathy - Inflammatory

Idiopathic | Pre-diabetic/Diabetic | Hereditary | Toxic/Secondary to Drugs | Inflammatory | Systemic/Metabolic |
Compression | Other Types of PN

• Polyarteritis Nodosa (PAN)
• Rheumatoid Arthritis
• Systemic Lupus Erythematosus (Lupus)
• Sjögren's Syndrome

Vasculitis is an inflammation of the blood vessel system, which includes the veins, arteries, and capillaries. Vasculitis may affect blood vessels of any type, size, or location, and therefore can cause dysfunction in any organ system, including the central and peripheral nervous system. Peripheral neuropathy may occur as a result of having vasculitis.

Vasculitis can be caused by infection of the blood vessel walls or an immune or "allergic" reaction in the vessel wall. The first cause is rare. When it occurs, bacteria, viruses or fungi infect the blood vessel. White blood cells move in to destroy the infectious agents and damage the blood vessel in the process. This is a serious condition and requires prompt antibiotic treatment.

The second cause of vasculitis, an immune reaction, is more common. Substances that cause allergic relations are called "antigens." They cause the body to make proteins called "antibodies" which bind to the antigen for the purpose of getting rid of it. Antigen and antibody bound together are called "immune complexes." Two primary ways in which immune complexes destroy antigens are by attracting white blood cells to digest the antigen, and by activating other body substances to help destroy the antigens.

The causes of most forms of vasculitis remain unknown. One kind of vasculitis that is not infrequently associated with peripheral neuropathy is polyarteritis nodosa. In addition, sarcoidosis can cause peripheral neuropathy from a vasculitis.

SYMPTOMS AND SIGNS

(Not all symptoms and signs may be present.)

• Anemia
• Fatigue
• Fever
• Muscle pain, numbness or tingling
• Night sweats
• Pain when chewing
• Severe headaches
• Stiffness
• Tenderness in the temple area
• Weight loss
• Vision loss

Also might include:

• Red or purple rash on skin, usually on the legs
• Aching in joints, and arthritis with pain, swelling, and heat in joints
• Headaches, behavioral disturbances, confusion, seizures, and strokes
• Peripheral nerve symptoms, including numbness and tingling
• Inadequate blood flow in the intestines causing abdominal pain and bloating
• Feeling of heaviness in the chest

EVALUATION AND TESTS

(Not all evaluation and tests may be necessary.)

• Neurological exam
• Electromyography
• Nerve conduction velocity test
• Blood tests
• CAT scan and MRI
• Chest x-ray
• Urine analysis

TREATMENT AND THERAPY

(Not all treatments and therapies may be indicated.)

The choice of treatment for vasculitis depends on: the severity of the vasculitis; your general health; your past reactions (positive and negative) to medications; and the particular type of vasculitis. Many cases of vasculitis do not require treatment.

• Corticosteroids [e.g. prednisone, prednisolone, or methylprednisolone (Medrol®)]
• Cytotoxic drugs (most commonly azathioprinc (Imuran®) and cyclophosphamide (Cytoxan®))
• Plasmapheresis
• Intravenous immunoglobulin (IVIg)
• Take safety measures to compensate for loss of sensation