Ischemic Monomelic Neuropathy after Arteriovenous Fistula Surgery: Clinical Features, Electrodiagnostic Findings, and Treatment

Abstract

Ischemic monomelic neuropathy (IMN) is a rare complication of vascular access in the hemodialysis patients, characterized by multiple mononeuropathies in the absence of clinical ischemia. Most commonly seen in the female gender, diabetes mellitus, and it must be differentiated from vascular steal syndrome, where we see clinical ischemia as the main pathognomonic feature. Early recognition of the symptoms and prompt intervention was shown to be beneficial. A delay in the treatment can lead to irreversible damage to the nerves and muscles. This article is depicting a case of an elderly male patient who presented with signs and symptoms of IMN which developed after arteriovenous (AV) fistula graft surgery.

Keywords: av fistula graft; diabetes; dialysis access associated steal syndrome (dass); emg/ncs; esrd (end stage renal disease); hemodialysis; ischemia; neuro-regeneration; post surgical pain; sensorimotor neuropathy.