Further Outpatient Care

See the list below:

Patients on cyclophosphamide require regular blood testing (ie, CBC).
Continue and encourage physical therapy. Patients may need splints for weakness; especially with foot drop, an ankle foot orthosis can stabilize gait.

Further Inpatient Care

See the list below:

Treatment and management of systemic manifestations of vasculitis require a multidisciplinary approach with consultation with other subspecialists.
Physical therapy is recommended if the patient's condition is clinically stable.
Obtain a nutrition consult for patients on long-term steroid treatment.

Graf J, Imboden J. Vasculitis and peripheral neuropathy. Curr Opin Rheumatol. 2019 Jan. 31 (1):40-45. [QxMD MEDLINE Link].
Collins MP, Dyck PJB, Hadden RDM. Update on classification, epidemiology, clinical phenotype and imaging of the nonsystemic vasculitic neuropathies. Curr Opin Neurol. 2019 Oct. 32 (5):684-695. [QxMD MEDLINE Link].
Kernohan JW, Woltman HW. Periarteritis nodosa: a clinicopathologic study with special reference to the nervous system. Arch Neurol Psychiatry. 1938. 39:655-86.
Dyck PJ, Benstead TJ, Conn DL, et al. Nonsystemic vasculitic neuropathy. Brain. 1987 Aug. 110 ( Pt 4):843-53. [QxMD MEDLINE Link].
Davies L, Spies JM, Pollard JD, McLeod JG. Vasculitis confined to peripheral nerves. Brain. 1996 Oct. 119 ( Pt 5):1441-8. [QxMD MEDLINE Link].
Kissel JT, Riethman JL, Omerza J, Rammohan KW, Mendell JR. Peripheral nerve vasculitis: immune characterization of the vascular lesions. Ann Neurol. 1989 Mar. 25(3):291-7. [QxMD MEDLINE Link].
Murthy JM, Sundaram C, Meena AK. Nonsystemic vasculitic neuropathy. J Assoc Physicians India. 1998 Feb. 46(2):204-6. [QxMD MEDLINE Link].
Larrode P, Ramon y Cajal S, Iníguez C, Dominguez M, Sanz JM, Morales F. [Isolated vasculitis of the peripheral nervous system]. Neurologia. 1997 May. 12(5):197-9. [QxMD MEDLINE Link].
Collins MP, Mendell JR, Periquet MI, Sahenk Z, Amato AA, Gronseth GS. Superficial peroneal nerve/peroneus brevis muscle biopsy in vasculitic neuropathy. Neurology. 2000 Sep 12. 55(5):636-43. [QxMD MEDLINE Link].
Sanchez GM, Villanueva-Haba VE, Sevilla Mantecon T, Mayordomo Fenandez F, Vilchez Padilla JJ. Nonsystemic vasculitic neuropathy. Neurologia. 2002. 17:613-5.
Vrancken AF, Said G. Vasculitic neuropathy. Handb Clin Neurol. 2013. 115:463-83. [QxMD MEDLINE Link].
Gwathmey KG, Burns TM, Collins MP, Dyck PJ. Vasculitic neuropathies. Lancet Neurol. 2014 Jan. 13(1):67-82. [QxMD MEDLINE Link].
Collins MP, Periquet MI, Mendell JR, Sahenk Z, Nagaraja HN, Kissel JT. Nonsystemic vasculitic neuropathy: insights from a clinical cohort. Neurology. 2003 Sep 9. 61(5):623-30. [QxMD MEDLINE Link].
Mathew L, Talbot K, Love S, Puvanarajah S, Donaghy M. Treatment of vasculitic peripheral neuropathy: a retrospective analysis of outcome. QJM. 2007 Jan. 100(1):41-51. [QxMD MEDLINE Link].
Kissel JT, Slivka AP, Warmolts JR, Mendell JR. The clinical spectrum of necrotizing angiopathy of the peripheral nervous system. Ann Neurol. 1985 Aug. 18(2):251-7. [QxMD MEDLINE Link].
Kararizou E, Davaki P, Karandreas N, Davou R, Vassilopoulos D. Nonsystemic vasculitic neuropathy: a clinicopathological study of 22 cases. J Rheumatol. 2005 May. 32(5):853-8. [QxMD MEDLINE Link].
Jayne D. Evidence-based treatment of systemic vasculitis. Rheumatology (Oxford). 2000 Jun. 39(6):585-95. [QxMD MEDLINE Link].
Jennette JC, Falk RJ, Andrassy K, Bacon PA, Churg J, Gross WL. Nomenclature of systemic vasculitides. Proposal of an international consensus conference. Arthritis Rheum. 1994 Feb. 37(2):187-92. [QxMD MEDLINE Link].
Frohnert PP, Sheps SG. Long-term follow-up study of periarteritis nodosa. Am J Med. 1967 Jul. 43(1):8-14. [QxMD MEDLINE Link].
Moore PM, Cupps TR. Neurological complications of vasculitis. Ann Neurol. 1983 Aug. 14(2):155-67. [QxMD MEDLINE Link].
Guillevin L, Cohen P, Gayraud M, Lhote F, Jarrousse B, Casassus P. Churg-Strauss syndrome. Clinical study and long-term follow-up of 96 patients. Medicine (Baltimore). 1999 Jan. 78(1):26-37. [QxMD MEDLINE Link].
Sehgal M, Swanson JW, DeRemee RA, Colby TV. Neurologic manifestations of Churg-Strauss syndrome. Mayo Clin Proc. 1995 Apr. 70(4):337-41. [QxMD MEDLINE Link].
Hirahara T, Yamashita S, Misumi Y, Kawakami K, Hori H, Honda S, et al. Gait disturbance due to foot drop is refractory to treatment in nonsystemic vasculitic neuropathy. Eur Neurol. 2014. 71(3-4):180-6. [QxMD MEDLINE Link].
Abgrall S, Mouthon L, Cohen P, et al. Localized neurological necrotizing vasculitides. Three cases with isolated mononeuritis multiplex. J Rheumatol. 2001 Mar. 28(3):631-3. [QxMD MEDLINE Link].
Hawke SH, Davies L, Pamphlett R, et al. Vasculitic neuropathy. A clinical and pathological study. Brain. 1991 Oct. 114 ( Pt 5):2175-90. [QxMD MEDLINE Link].
Johnson R, Griffin J. Current Therapy in Neurologic Disease. 5th ed. Philadelphia: BC Decker;. 1997.
Kissel JT, Mendell JR. Vasculitic neuropathy. Neurol Clin. 1992 Aug. 10(3):761-81. [QxMD MEDLINE Link].
Olney RK. Neuropathies associated with connective tissue disease. Semin Neurol. 1998. 18(1):63-72. [QxMD MEDLINE Link].
Said G. Vasculitic neuropathy. Curr Opin Neurol. 1999 Oct. 12(5):627-9. [QxMD MEDLINE Link].
Satoi H, Oka N, Kawasaki T, et al. Mechanisms of tissue injury in vasculitic neuropathies. Neurology. 1998 Feb. 50(2):492-6. [QxMD MEDLINE Link].
Vedeler CA. Inflammatory neuropathies: update. Curr Opin Neurol. 2000 Jun. 13(3):305-9. [QxMD MEDLINE Link].

Media Gallery

Diagnostic classification of peripheral vasculitic neuropathy (PVN).

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Author

Abbas Mehdi, MD Director, MDA Center of Central California; Consulting Staff, Department of Neurology, California Neurological Center, Inc

Abbas Mehdi, MD is a member of the following medical societies: American Academy of Neurology, American Epilepsy Society, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Said R Beydoun, MD Chief, Professor, Department of Neurology, University Hospital, University of Southern California

Said R Beydoun, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Glenn Lopate, MD Associate Professor, Department of Neurology, Division of Neuromuscular Diseases, Washington University in St Louis School of Medicine; Consulting Staff, Department of Neurology, Barnes-Jewish Hospital

Glenn Lopate, MD is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Nicholas Lorenzo, MD, CPE, MHCM, FAAPL Co-Founder and Former Chief Publishing Officer, eMedicine and eMedicine Health, Founding Editor-in-Chief, eMedicine Neurology; Founder and Former Chairman and CEO, Pearlsreview; Founder and CEO/CMO, PHLT Consultants; Former Chief Medical Officer, MeMD Inc

Nicholas Lorenzo, MD, CPE, MHCM, FAAPL is a member of the following medical societies: Alpha Omega Alpha, American Academy of Neurology, American Association for Physician Leadership

Disclosure: Nothing to disclose.

Additional Contributors

Norman C Reynolds, Jr, MD Neurologist, Veterans Affairs Medical Center of Milwaukee; Clinical Professor, Medical College of Wisconsin

Norman C Reynolds, Jr, MD is a member of the following medical societies: American Academy of Neurology, Association of Military Surgeons of the US, International Parkinson and Movement Disorder Society, Sigma Xi, The Scientific Research Honor Society, Society for Neuroscience

Disclosure: Nothing to disclose.