Mononeuritis multiplex, occasionally termed polyneuritis multiplex, is simultaneous or sequential involvement of individual noncontiguous 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. The pattern of involvement is asymmetric, however, as the disease progresses, deficit(s) becomes more confluent and symmetrical, making it difficult to differentiate from polyneuropathy. Therefore, attention to the pattern of early symptoms is important.
Mononeuritis multiplex also may 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 typically is encountered as acute, unilateral, and severe thigh pain followed by anterior muscle weakness and loss of knee reflex.
Symptoms will depend on the specific nerves involved, and may include:
- Loss of bladder or bowel control
- Loss of sensation in one or more areas of the body
- Paralysis in one or more areas of the body
- Tingling, burning, pain, or other abnormal sensations in one or more areas of the body
- Weakness in one or more areas of the body
To improve independence, treatments may include:
- Occupational therapy
- Orthopedic help (for example, appliances such as wheelchairs, braces, and splints)
- Physical therapy (for example, exercises and retraining to increase muscle strength)
- Vocational therapy
The goals of treatment are to:
- Treat the illness that is causing the problem, if possible
- Provide supportive care to maximize independence
- Control symptoms (this may include controlling blood sugar levels for diabetics, nutritional supplementation, or medically treating conditions)
- Changes in work habits
- Avoid the activities that precipitate the injury to the nerve.
- Anti inflammatory medication may be helpful.
In chronic neuropathies where conservative measures are failed to relive surgical treatment is required.