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Mononeuritis Multiplex, How???


  I hope someone will take the time to read this. I have had many symptoms. About 2 years ago, I started to have severe
  abdominal pain with constipation, twitching in my abdomen, low grade fever (99.5), malaise,and increased sweating under the
  arms and in the palms. After many tests (Up/Low GI, x-rays, blood tests) they found nothing, and diagnosed me with IBS.
  Fiber helps with the regularity, but all other symptoms are still with me. The muscle twitches have spread to other areas in my
  arms and legs, and are annoying more than anything else.>>>In December '97, I had a bad virus that subsided with Bactrim.
  Shortly thereafter, I started to have serious pain in the right shoulder. This spread to the back of my neck, to the other shoulder,
  and eventually through my arms to the hands. During the pain, I started to have weakness, numbness, and eventually almost an
  entire loss of use in my left hand. My right is slightly compromised, but still useable. I have had blood tests for;Lupus, Vasculitis,
  HIV, Lyme, Diabetes, Thyroid, and HNPP - all were negative. I have also had CAT scans of the chest, abdomen, and pelvis -
  normal. MRI of left arm (showed atrophy only), and the neck (slight protrusion on rt side). Nerve biopsy - normal. EMG
  diagnosis was "mononeuritis multiplex". The physical therapist thinks there is scar tissue on the tendons in the back of my right
  hand. My neurologist has decided to "wait and see" what happens. Can someone help me with other possible diagnoses?
  Please respond via e-mail as well as posting.
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Sorry about the late response.
I'm not sure what you have, but maybe an explanation of mononeuritis multiplex might help your understanding.
Neuropathy is a generic term implying malfunction or damage to peripheral nerves. This is distinct from myopathy (muscle disease), radiculopathy (nerve root disease), and myelopathy (spinal cord disease).
Neuropathies come in many patterns. A mononeuropathy is damage to a single nerve, for example from a compression injury. Carpal Tunnel Syndrome is a mononeuropathy of the median nerve, for example. Polyneuropathy is several nerves involved at the same time. A common polyneuropathy is the one that diabetics get, where nerves in toes, feet, ankles, and legs below the knees are involved.
A mononeuritis multiplex is a changing pattern over time, in which first one mononeuropathy happens, then another, then another. Usually the next mononeuropathy occurs after the first one resolves. You can see that term refers to a PATTERN of neuropathy, rather than a specific cause. There are quite a few causes, and it is appropriate that you were tested for connective tissue disease (Lupus etc), vasculitis, HIV, Lyme disease. HNPP is a classic hereditary mononeuritis multiplex which is transmitted via chromosome 17, and it too is worth considering.
I can't say really whether your symptoms all fit any of the above, and can't really provide any diagnostic hints. But I hope you at least understand a bit more about the thinking behind the diagnosis. If this makes you want a second opinion, you are welcome to call 800 223-2273 and ask for neurology appointments - specify neuromuscular specialists. I hope this helps. CCF MD mdf.




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