Introduction: Mononeuropathy multiplex is a clinical syndrome characterized by asymmetric sensory an

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Mononeuropathy Multiplex A Case Report
Jonathan B. Stone, D.O., Robert R. Conway,
M.D. Department of Physical Medicine and
Rehabilitation, University of Missouri, Columbia,
Missouri
Electrodiagnostic Findings Motor Summary Table
Electromyography Table

• IntroductionMononeuropathy multiplex is a
  clinical syndrome characterized by asymmetric
  sensory and motor neuropathies which may include
  multiple sensory cutaneous or mixed peripheral
  nerves. The syndrome is relatively uncommon with
  multiple potential etiologies. It may be
  primarily demyelinating or axonal. Presented
  here is a case of a nineteen year old white male
  with an axonal form of mononeuropathy multiplex
  confirmed by electrodiagnostic studies.
• Case Description
• History
• Nineteen year old white male.
• Multiple drug overdose causing rhabdomyolysis and
  acute renal failure.
• Inpatient rehabilitation for metabolic and anoxic
  encephalopathy.
• Noted problems with neuropathic pain and
  sensorimotor changes in extremities.
• Paresthesias in both hands and right lower
  extremity.
• Physical Exam
• Flaccid right foot and ankle.
• Weakness with grip strength and intrinsic muscles
  in the left hand.
• Summary of Electrodiagnostic Findings

APBAbductor Pollicis Brevis, ADMAbductor Digiti
Minimi, EDBExtensor Digitorum Brevis,
AH Abductor Hallucis, On LatOnset Latency,
AmpAmplitude, CVConduction Velocity.
Sensory Summary Table
Electrodiagnostic studies revealed evidence of a
MU AmpMotor Unit Amplitude, PolyPolyphasia,
CRDComplex Repetitive Discharge, DecrDecreased,
IncrIncreased, PTPronator Teres, FPLFlexor
Pollicis Longus, APB Abductor Pollicis Brevis,
FDIFirst Dorsal Interosseous, FDPFlexor
Digitorum Profundus, EIPExtensor Indicis
Proprius, FDSFlexor Digitorum Superficialis,
VMVastus Medialis, EHLExtensor Hallucis Longus
Conclusion These findings are consistent with
mononeuropathy multiplex. Mononeuropathy
multiplex has a wide differential diagnosis
including ischemia from diabetes, vasculitis,
amyloidosis, drug induced, demyelinating process,
infection, multiple compressions, and neoplastic
or granulomatous infiltration. It can be a
manifestation of critical illness neuropathy,
which is believed to be the etiology in this
case. Mononeuropathy multiplex is an important
syndrome for all physiatrists to be familiar
with.