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Neurological involvement in Wegener's granulomatosis was studied by reviewing the charts of 324 consecutive patients in whom the diagnosis was made at the Mayo Clinic.One hundred nine patients(33.6%)had neurological involvement.Peripheral neuropathy occurred in 53;cranial neuropathy,in 21; external ophthalmoplegia,in 16;cerebrovascular events,in 13;seizures,in 10;cerebritis,in 5;and miscellaneous involvement,in 25.The mean age and sex ratio were similar in the patients with and those without neurological involvement.Among the patients with peripheral neuropathy,42 had mononeuropathy multiplex;6,distal symmetrical polyneuropathy;and 5, unclassified peripheral neuropathy.Multiple mononeuropathy was a major presenting symptom in 8 patients.A significantly higher percentage of patients with peripheral neuropathy,compared to those without peripheral neuropathy,had kidney involvement(p<0.001).The second,sixth,and seventh cranial nerves were most frequently affected.Multiple cranial nerves were affected in 8 patients.Unusual neurological manifestations in the miscellaneous group were spastic paraparesis,temporal arteritis,Horner's syndrome,and papilledema. |
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