Watcharasarn Rattananan1, Pariwat Thaisetthawatkul2, P James B Dyck3. 1. Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States. 2. Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States. Electronic address: pthaiset@unmc.edu. 3. Department of Neurology, Mayo Clinic, Rochester, MN, United States.
Abstract
BACKGROUND: Clinical and pathologic descriptions of postsurgical inflammatory neuropathy have been reported but this condition is still under recognized. METHODS: We reviewed 5 cases of a biopsy-proven inflammatory neuropathy that occurred within 30 days after surgical procedures. These patients were seen at one center in a 2-year period. RESULTS: All patients developed neuropathy symptoms with time delay between the surgery and the neuropathy onset. In all, the symptoms progressed up to the time of evaluation. Electrophysiological studies revealed mononeuropathy or asymmetrical polyneuropathy with active denervation. Nerve biopsies showed ischemic injury and perivascular inflammatory collections in all cases. All patients were treated with intravenous methylprednisolone and four of them showed clinical improvement. The non-responsive patient did not receive immunotherapy until 2 years after neuropathy onset. CONCLUSIONS: The report illustrates that focal or asymmetrical neuropathy is typical of postsurgical inflammatory neuropathy and has a favorable outcome after intravenous corticosteroid treatment. The report underscores the importance for considering potentially treatable inflammatory neuropathies in the post-surgical setting.
BACKGROUND: Clinical and pathologic descriptions of postsurgical inflammatory neuropathy have been reported but this condition is still under recognized. METHODS: We reviewed 5 cases of a biopsy-proven inflammatory neuropathy that occurred within 30 days after surgical procedures. These patients were seen at one center in a 2-year period. RESULTS: All patients developed neuropathy symptoms with time delay between the surgery and the neuropathy onset. In all, the symptoms progressed up to the time of evaluation. Electrophysiological studies revealed mononeuropathy or asymmetrical polyneuropathy with active denervation. Nerve biopsies showed ischemic injury and perivascular inflammatory collections in all cases. All patients were treated with intravenous methylprednisolone and four of them showed clinical improvement. The non-responsive patient did not receive immunotherapy until 2 years after neuropathy onset. CONCLUSIONS: The report illustrates that focal or asymmetrical neuropathy is typical of postsurgical inflammatory neuropathy and has a favorable outcome after intravenous corticosteroid treatment. The report underscores the importance for considering potentially treatable inflammatory neuropathies in the post-surgical setting.
Authors: Darryl B Sneag; Susan C Lee; Joseph H Feinberg; Darius P Melisaratus; Ian Amber Journal: Skeletal Radiol Date: 2017-07-28 Impact factor: 2.199