多发性单神经病要点.doc

multiple mononeuropathy 1. Neurol Neuroimmunol Neuroinflamm. 2015 Nov 12;3(1):e180. doi: 10.1212/NXI.0000000000000180. eCollection 2016. Vasculitic neuropathy following exposure to minocycline. Baratta JM(1), Dyck PJ(1), Brand P(1), Thaisetthawatkul P(1), Dyck PJ(1), Engelstad JK(1), Goodman B(1), Karam C(1). Author information: (1)Departments of Physical Medicine Rehabilitation (J.M.B.) and Neurology (C.K.), The University of North Carolina, Chapel Hill; the Department of Neurology (P.J.B.D., P.B., P.J.D., J.K.E.), Mayo Clinic, Rochester, MN; the Department of Neurological Sciences (P.T.), University of Nebraska Medical Center, Omaha; and the Department of Neurology (B.G.), Mayo Clinic, Scottsdale, AZ. OBJECTIVE: To report 3 patients with minocycline-induced autoimmunity resulting in peripheral nerve vasculitis. METHODS: We report 3 patients who, during minocycline treatment for acne vulgaris, developed subacute onset of pain and weakness caused by vasculitis in single and multiple mononeuropathy patterns. RESULTS: Each patient underwent either a nerve or muscle biopsy that confirmed vasculitis. One patient additionally developed systemic symptoms (including fever, fatigue, and night sweats) and another had a posterior circulation stroke. Symptoms developed with either early or prolonged use of minocycline. Despite withdrawal of minocycline, patients needed long-term immunotherapy to gain neurologic improvement. CONCLUSIONS: Our findings suggest that the typical neuropathy associated with minocycline use is painful single or multiple mononeuropathy due to peripheral nerve vasculitis, which may also be accompanied by presumed CNS vasculitis (presenting as stroke). PMCID: PMC4645168 PMID: [PubMed] 2. JAMA Neurol. 2015 Dec 1;72(12):1510-8. doi: 10.1001/jamaneurol.2015.2347. The Importance of Rare Subtypes in Diagnosis and Treatment of Peripheral Neuropathy: A Review. Callaghan BC(1), Price RS(2), Chen KS(3), Feldman EL(1). Author informa