• Sindhu Ramchandren, Vinay Chaudhry, Ahmet Hoke, Beth B Murinson, David R Cornblath, Glenn J Treisman, and John W Griffin.
• Department of Neurology, Wayne State University, Detroit Medical Center, University Health Center 8C20, Detroit, MI 48201, USA. sramchan@med.wayne.edu
• J Clin Neuromuscul Dis. 2008 Dec 1;10(2):61-4.

ObjectiveTo report the clinical, electrodiagnostic, and pathologic findings in 3 patients who presented with complex regional pain syndrome as their primary manifestation of peripheral nerve vasculitis.DesignCase series.SettingOutpatient clinic in a tertiary care academic medical center.PatientsPatient 1 was a 39-year-old woman with a 9-year history of non-length-dependent severe burning pain and swelling in her extremities. Patient 2 was a 67-year-old man with a 2-year history of severe burning pain and swelling in an extremity after a fall. Patient 3 was a 74-year-old man with a 6-month history of severe allodynic pain and atrophy of the right hand after a viral illnessResultsIn all 3 cases, clinical and electrodiagnostic testing were suggestive of multiple mononeuropathies. Nerve biopsy either confirmed vasculitis (patient 1) or was suggestive of angiopathy (patients 2 and 3). Immunomodulative therapy led to marked clinical improvement in all 3 cases.ConclusionsTo our knowledge, this is the first report demonstrating that the inflammatory nerve injury seen with peripheral nerve vasculitis can result in complex regional pain syndrome. Clinical and electrodiagnostic assessments can help in the identification and management of these patients.

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