Ischemic monomelic neuropathy

Abstract

Ischemic monomelic neuropathy is a rare complication associated with arteriovenous fistula creation for hemodialysis. It is an acutely developing ischemic neuropathy involving multiple nerves of a single limb. The pathogenesis is thought to be decreased blood flow to the distal axons, due to the shunting of blood away from the distal limb. It is characterized by severe pain and muscle weakness along with multiple nerve distributions, confined to the limb. It is different from steal syndrome in that there is no muscle or skin necrosis. It is often a debilitating condition warranting immediate closure of the fistula. Hence, prompt recognition of this entity is essential. Hereby, we report the case of a 60-year-old male with chronic kidney disease, who underwent a brachiocephalic fistula creation in the left upper limb and developed features of ischemic monomelic neuropathy.

Keywords

• brachiocephalic fistula
• hemodialysis
• ischemic monomelic neuropathy