Peripheral neuropathies after arthropod stings not due to Lyme disease: a report of five cases and review of the literature.
Five patients developed neurologic symptoms a few hours to 2 months after being stung by a non-hooking arthropod with immediate cutaneous reaction. The patients had no clinical or serologic evidence for Lyme borreliosis and rickettsial disease. Clinical and electrophysiologic findings were consistent with a mixed axonal and demyelinating mononeuropathy, a monomelic multiple mononeuropathy, a mononeuropathy multiplex, a radiculoneuritis, and a distal symmetric polyneuropathy. Muscle and nerve biopsies showed lymphoplasmacytic small-vessel vasculitis in all patients, and wallerian degeneration in three. These patients, and 17 others from the literature, indicate a spectrum of peripheral neuropathies occurring after insect and spider stings.
Créange
A
A
Service de Neurologie, Hôpital Henri Mondor, Créteil, France.
Saint-Val
C
C
Guillevin
L
L
Degos
J D
JD
Gherardi
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001181:Arthropods; D001733:Bites and Stings / Q000382:microbiology; D015748:Borrelia burgdorferi Group / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D008193:Lyme Disease / Q000150:complications / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000503:physiopathology