Unusual Urgent Case Presenting to the EDX Lab: Mononeuropathy Monoplex.
Julia Dispirito, Cole Hedden, Kendall Prowse et al.
✦ AI-curated · Sources linked
Case in brief
A previously healthy 30-year-old woman developed sudden left leg pain, tingling, and sensory loss after hospitalization for presumed urosepsis. Examination localized weakness and sensory dysfunction to the sciatic nerve, and electrodiagnostic testing showed an axonal sciatic neuropathy. Amaurosis fugax, persistent fever, and elevated inflammatory markers raised concern for systemic vasculitis with emerging mononeuropathy multiplex. Sural nerve biopsy confirmed vasculitis, and cyclophosphamide treatment was started.
What made this case unusual
The focal sciatic neuropathy occurred alongside amaurosis fugax and systemic inflammatory features, pointing to vasculitis rather than an isolated peripheral nerve lesion.
Diagnostic / clinical pearl
An unexplained focal mononeuropathy accompanied by systemic inflammatory features or transient visual loss should prompt consideration of vasculitis and timely diagnostic evaluation.
Why it matters
The report emphasizes that delayed diagnosis or treatment may lead to irreversible disability or death.