Tingling, burning, pain, or other abnormal sensations in one or more areas of the body
Weakness in one or more areas of the body
Signs and tests
A detailed history is needed to determine the possible cause of the disorder. Examination and neuromuscular testing may show a loss of feeling and movement due to problems with specific nerves. Reflexes may be abnormal.
To diagnose mononeuritis multiplex, there usually needs to be problems with two or more unrelated nerve areas. Common nerves affected are the:
Treat the illness that is causing the problem, if possible
Provide supportive care to maximize independence
Control symptoms (this may include controlling blood sugar levels for diabetics, nutritional supplementation, or medically treating conditions)
To improve independence, treatments may include:
Orthopedic help (for example, appliances such as wheelchairs, braces, and splints)
Physical therapy (for example, exercises and retraining to increase muscle strength)
Safety is an important consideration for people with sensation or movement difficulties. Lack of muscle control and decreased sensation may increase the risk of falls or injuries. Safety measures for people with movement difficulty include:
Adequate lighting (including leaving lights on at night)
Removing obstacles (such as loose rugs that may slip on the floor)
Testing water temperature before bathing
Wearing protective shoes (no open toes or high heels)
Check shoes often for grit or rough spots that may injure the feet.
People with decreased sensation should check their feet (or other affected area) often for bruises, open skin areas, or other injuries that may go unnoticed. These injuries may become severely infected because the pain nerves of the area are not signaling the injury.
People with mononeuropathy multiplex are prone to new nerve injuries at pressure points such as knees and elbows. They should avoid putting pressure on these areas, for example by not leaning on the elbows, crossing the knees, or holding similar positions.
Medications that may help include:
Over-the-counter pain medicines (ibuprofen or acetaminophen) or prescription pain medications may be needed to control pain (neuralgia).
Anticonvulsants (gabapentin, phenytoin, carbamazepine, or pregabalin) or antidepressants (amitriptyline, nortriptyline, or duloxetine), may be used to reduce stabbing pains.
Whenever possible, avoid or minimize the use of medications to reduce the risk of side effects.
Positioning (the use of frames to keep bedclothes off of a tender body part) and other measures may help control pain. Autonomic symptoms can be difficult to treat or respond poorly to treatment.
If the cause can be found and successfully treated, and if damage is limited, a full recovery is possible. The amount of disability can range from no disability, to partial or complete loss of movement, function, or sensation.
Nerve pain may be quite uncomfortable and can last for a long time. If this occurs, see a pain specialist to ensure that all pain treatment options are available to you.
Deformity, loss of tissue or muscle mass
Disturbances of organ functions
Medication side effects
Repeated or unnoticed injury to the affected area due to lack of sensation
Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.