The involvement of the peripheral nervous system in biopsy proven active giant cell arteritis.
BACKGROUND
Peripheral nervous system (PNS) affection is an uncommon, sometimes life-threatening manifestation of giant cell arteritis (GCA).


OBJECTIVE
To describe characteristics of neurological abnormalities of the PNS in GCA patients.


METHODS
Eighty consecutive cases of biopsy proven GCA were studied.


RESULTS
Three patients presented with subacute sensorimotor deficits abnormalities in the distribution of the arm plexus. In all cases PNS affection was the leading clinical symptom in addition to a typical clinical syndrome of cranial arteriitis. In one case MRI demonstrated diffuse signal abnormalities surrounding the brachial nerve plexus. In another patient, who died from pulmonary embolism 10 weeks after beginning of therapy, autopsy demonstrated residual arteritis in an artery supplying the brachial nerve plexus.


CONCLUSIONS
Involvement of the PNS is more uncommon than cerebral ischemia and neuroophthalmological complications in patients suffering from GCA. Severe PNS involvement has an affinity to the midcervical nerve roots and the brachial nerve plexus.
Pfadenhauer
K
K
Dept. of Neurology and Clinical Neurophysiology, Klinikum Augsburg, Stenglinstr. 2, 86156 Augsburg, Germany. karl.pfadenhauer@neurologie.augsburg-med.de
Roesler
A
A
Golling
A
A
D000368:Aged; D000369:Aged, 80 and over; D001132:Arm / Q000294:innervation / Q000503:physiopathology; D001366:Axillary Artery / Q000473:pathology / Q000503:physiopathology; D001706:Biopsy; D001917:Brachial Plexus / Q000098:blood supply / Q000473:pathology / Q000503:physiopathology*; D020516:Brachial Plexus Neuropathies / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D002572:Cervical Plexus / Q000473:pathology / Q000503:physiopathology; D017809:Fatal Outcome; D005260:Female; D013700:Giant Cell Arteritis / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology*; D011446:Prospective Studies; D011655:Pulmonary Embolism / Q000150:complications; D011843:Radiculopathy / Q000209:etiology / Q000503:physiopathology; D012678:Sensation Disorders / Q000209:etiology / Q000503:physiopathology; D013348:Subclavian Artery / Q000473:pathology / Q000503:physiopathology