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May 1968

Ischemic Mononeuropathy Multiplex Associated With Diabetes Mellitus

Author Affiliations

From the Charles S. Kubik Laboratory for Neuropathology of the James Homer Wright Pathology Laboratories, and the Kennedy Laboratories, Neurology Service, Massachusetts General Hospital, and the departments of neuropathology and neurology, Harvard Medical School, Boston.

Arch Neurol. 1968;18(5):487-499. doi:10.1001/archneur.1968.00470350045004

MONONEUROPATHY multiplex is a syndrome characterized by simultaneous or successive dysfunction of several peripheral nerve trunks remote from one another. It thus differs from polyneuropathy which implies a more diffuse and symmetrical disorder. The causes of mononeuropathy multiplex include polyarteritis nodosa, disseminated lupus erythematosis, sarcoidosis, amyloidosis, hemophilia, leprosy, trauma, and involvement of nerve by tumor. It also occurs in patients with diabetes mellitus, and when no other cause is found, it is attributed to the diabetes and is classified among the diabetic neuropathies. However, its relationship to the other forms of diabetic neuropathy is unclear, and as is the case for all of them, the pathology and the pathogenesis are unsettled.

Diabetic mononeuropathy multiplex tends to affect elderly patients with mild, or undiscovered, diabetes. It has an acute or subacute onset with a tendency to recover over a period of months, and usually causes a painful, asymmetrical, often proximal

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