Vasculitic neuropathy : clinical electrophysiological and histopathological characterstics.

The clinical, electrophysiological and pathological features of 16 patients with vasculitic neuropathy were evaluated. Vasculitic neuropathy accounted for 5.3 of biopsy proven cases of various neuropathies. They included 7 cases of systemic vasculitic neuropathy (SVN) and 9 cases of nonsystemic vasculitic neuropathy (NSVN). Mononeuritis multiplex, both clinically and electrophysiologically was seen in neoropathy in 11 (69.7) patients. Three patients had sensory neuropathy. All the patients had anecrotizing vasculitis on nerve biopsy. Axonal degeneration was seen in teased fibers in all the patients. Fifteen patients were treated with steroids and one patient with cyclophosphamide. Seven patients with NSVN recovered completely. Two patients withSVN were left with asymmetical foot drop and one patient with NSVN developed bilateral mild claw hands. There were no deaths.

Brachial plexus and related lesions after median sternotomy.

A prospective study was undertaken in 459 cases, undergoing open heart surgery which necessitated media sternotomy, to see the frequency of brachial plexus and peripheral nerve related complications in the upper limbs. Seven cases (1.53) had such complications. These included lower trunk injury (3 cases), ulnar neuropathy at the elbow (3 cases), and radical neuropathy at the level of radical groove (one case). The youngest patient was aged 12 years and the remaining 6 patients were more than 30 years of age. There was no relation between the type of heart disease and these complications. The difference between patients with or without preparation of the internal mammary artery for graft was not significant. All the complications occurred on the left side. Ulnar and radical nerve palsy could be due to the positioning of the left limb. The barchial plexus injury was related to retraction of the sternum during operation. AA : Y.