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Sensory neuropathy in vasculitis

A clinical, pathologic, and electrophysiologic study

From the Department of Rehabilitation Medicine (Dr. Seo), School of Medicine, Chonbuk National University, Chonju, Republic of Korea; and Department of Neurology (Drs. Ryan, Claussen, Thomas, and Oh), School of Medicine, University of Alabama at Birmingham, and Department of Veterans Affairs Medical Center, Birmingham, AL.

Address correspondence and reprint requests to Dr. S.J. Oh, Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL 35294; e-mail: shinjoh{at}uab.edu

Background: Vasculitis is not usually considered as a cause of symmetric sensory neuropathy.

Objective and methods: To present the clinical, pathologic, and electrophysiologic features of 17 (16%) cases of sensory neuropathy in vasculitis (SNV) among 106 cases with histologically proven vasculitic neuropathy that were collected over the last 30 years.

Results: In 41% of cases, SNV was found as systemic vasculitic neuropathy in association with primary vasculitic disease. The most common clinical presentation was symmetric polyneuropathy, seen in 53% of cases. The most common nerve conduction pattern was diffuse neuropathy pattern of axonal degeneration. Sural nerve biopsy was diagnostic in 88% of cases. In two cases, muscle biopsy was necessary for the definite diagnosis of vasculitis. Non-systemic SNV is usually benign. Of 11 patients followed for longer than 2 years, none developed motor weakness due to neuropathy.

Conclusion: Sensory neuropathy, regardless of symmetry, can be due to vasculitis.

Received February 9, 2004. Accepted in final form May 14, 2004.

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