Vasculitic neuropathy--electrodiagnostic findings and association with malignancies.
BACKGROUND
Vasculitic neuropathies occur in the context of systemic disorders or in isolation. Histopathologic evaluation remains the gold standard for diagnosis, but certain electrodiagnostic findings may heighten suspicion of vasculitic neuropathy and improve the yield of nerve and muscle biopsy.


OBJECTIVE
Description of electrodiagnostic patterns associated with vasculitic neuropathies, and a report of a possible association with malignancies.


METHODS
Retrospective review of medical records of patients with histopathologically proven vasculitic and non-vasculitic axonal neuropathies evaluated at the University of Pittsburgh Medical Center from November 1995 to November 2003.


RESULTS
The most distinctive electrodiagnostic patterns associated with vasculitic neuropathy were mononeuritis multiplex (27.5% vs 4% in controls; P = 0.003) and axonal sensorimotor polyneuropathy with side-to-side amplitude asymmetry (50% vs 32%, P > 0.05). Additionally, six patients (15% vs 2%; P = 0.034) developed various malignancies within 2 years of onset of vasculitic neuropathy.


CONCLUSIONS
While generalized polyneuropathy was the most common presentation of nerve vasculitis, our study affirms side-to-side amplitude asymmetry and mononeuritis multiplex as the most distinctive electrodiagnostic features. The frequent occurrence of malignancies suggests a possible association with the vasculitic neuropathy and warrants additional investigation.
Zivković
S A
SA
VA Pittsburgh Healthcare System, and University of Pittsburgh Medical Center, 3471 Fifth Avenue #811, Pittsburgh, PA 15213, USA. zivkovics@upmc.edu
Ascherman
D
D
Lacomis
D
D
D000200:Action Potentials / Q000502:physiology; D000368:Aged; D000369:Aged, 80 and over; D001369:Axons / Q000473:pathology; D001706:Biopsy; D015984:Causality; D015897:Comorbidity; D003240:Connective Tissue Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D004568:Electrodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016472:Motor Neuron Disease / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D009369:Neoplasms / Q000453:epidemiology; D009431:Neural Conduction / Q000502:physiology; D010257:Paraneoplastic Syndromes / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D011115:Polyneuropathies / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D014657:Vasculitis / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*