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Mononeuropathy

Definition

Mononeuropathy is damage to a single nerve or nerve group, which results in loss of movement or sensation.

Alternative Names

Neuropathy - isolated

Causes, incidence, and risk factors

Mononeuropathy is a type of peripheral neuropathy (damage to nerves outside the brain and spinal cord).

Mononeuropathy is most often caused by injury, although systemic (body wide) disorders may cause isolated nerve damage. For example, mononeuritis multiplex. Prolonged pressure on the nerve due to swelling or injury can result in mononeuropathy. The covering of the nerve ( myelin sheath) or part of the nerve cell (the axon) is destroyed. This damage slows or prevents signaling through the nerves.

Mononeuropathy may involve any part of the body. Some of the common forms of mononeuropathy include:

• Sciatic nerve dysfunction
• Common peroneal nerve dysfunction
• Radial nerve dysfunction
• Ulnar nerve dysfunction
• Cranial mononeuropathy VI
• Cranial mononeuropathy VII
• Cranial mononeuropathy III; compression type
• Cranial mononeuropathy III; diabetic type
• Axillary nerve dysfunction
• Carpal tunnel syndrome
• Femoral nerve dysfunction
• Tibial nerve dysfunction

Symptoms

• Numbness, decreased sensation
• Tingling, burning, pain, abnormal sensations
• Loss of sensation
• Weakness
• Paralysis (total loss of movement)

Note: Symptoms are isolated to one part of the body.

Signs and tests

Neuromuscular examination may show which nerve is involved. Reflexes may be abnormal in the area.

Tests may include:

• EMG (a recording of electrical activity in muscles)
• Nerve conduction tests
• Nerve biopsy

Testing may also include various blood tests, x-rays, and imaging scans.

Treatment

The goal of treatment is to allow the person to use the affected body part as much as possible.

The cause of the mononeuropathy should be identified and treated as appropriate. In some cases, no treatment is required and the person gets better on their own.

High blood pressure and diabetes can cause injury to an artery, which can often affect a single nerve. The underlying condition should be treated.

Corticosteroids injected into the area may reduce swelling and pressure on the nerve. Surgery may be recommended if the symptoms are caused by entrapment of the nerve. Surgery to relieve the pressure on the nerve may help in some cases.

Medications:

• Over-the-counter or prescription pain medicine may be needed to control pain (neuralgia).
• Prescription medications may be used to reduce stabbing pains, including gabapentin, pregabalin, phenytoin, carbamazepine, duloxetine, or tricyclic antidepressants such as amitriptyline or nortriptyline. Whenever possible, the use of these drugs should be avoided or minimized to reduce the risk of medication side effects.

Other Treatments:

• Physical therapy exercises to maintain muscle strength
• Orthopedic braces, splints, or other appliances
• Vocational counseling, occupational therapy, occupational changes, job retraining, or similar interventions

Expectations (prognosis)

Mononeuropathy may be disabling and painful. If the cause of the nerve dysfunction can be identified and successfully treated, there is a possibility of full recovery.

The extent of disability varies from no disability to partial or complete loss of movement or sensation. Nerve pain may be quite uncomfortable and persist for a long period of time.

Complications

• Recurrent or unnoticed injury to the affected area due to lack of sensation
• Mild to severe deformity
• Decreased self-esteem
• Medication side effects

Calling your health care provider

Call your health care provider if symptoms of nerve dysfunction are present. Early diagnosis and treatment increase the chance of controlling symptoms.

Prevention

Avoiding pressure or traumatic injury may prevent many forms of mononeuropathy. Treating underlying medical conditions such as high blood pressure or diabetes also decreases risk of developing the condition.

Review Date:9/10/2006
Reviewed By:Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network.

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