Appendix A: Case Definitions for Neuropsychiatric Syndromes in Systemic Lupus Erythematosus
Mononeuropathy (single/multiplex)
Disturbed function of one or more peripheral nerve(s) resulting in weakness/paralysis or sensory dysfunction due to either conduction block in motor nerve fibers or axonal loss.
Conduction block is related to demyelination with preservation of axon continuity. Remyelination may be rapid and complete. If axonal interruption takes place, axonal degeneration occurs below the site of interruption and recovery is often slow and incomplete. Sensory symptoms and sensory loss may affect all modalities or be restricted to certain forms of sensation.
Diagnostic criteria:
- Clinical demonstration of motor/sensory disturbances in the distribution of a peripheral nerve and/or
- Abnormalities on nerve conduction studies or EMG (i.e., concentric needle examination)
Associations:
- Diabetic neuropathy
- Local damage from mechanical injury, radiation, malignancy, sarcoid
- Infection: Lyme, HIV, herpes
- Vasculitis; polyarteritis nodosa, Wegener’s granulomatosis, cryoglobulinemia, rheumatoid arthritis, Sjögren’s syndrome, etc.
Ascertainment:
History and examination (including nerve conduction studies)
Record:
- Basic descriptors with the following modifications:
- Onset (acute or insidious)
- Description of neurologic deficit
- Course (acute: hours to days/subacute: weeks/chronic: months to years)
(Reference: 111)
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