Ischemic monomelic neuropathy.

Ischemic monomelic neuropathy (IMN) is an infrequently recognized type of ischemic neuropathy produced by the shunting of blood away from, or the acute noncompressive occlusion of, a major proximal limb artery. IMN consists of multiple axonal-loss mononeuropathies that develop acutely and simultaneously in the distal portion of a limb. We found stereotyped clinical and EMG features in 14 patients. In six the IMN was thromboembolic in nature, whereas in eight it was due to various vascular surgical procedures. Our experience with IMN suggests that distal axonal infarction can occur without significant muscle necrosis, supporting the hypothesis that in humans the distal nerve fibers are more vulnerable than muscle to acute noncompressive limb ischemia.