Electrophysiological Study of Nerve Involvement in Rheumatoid Arthritis

Abstract

Background and Aim: Rheumatoid arthritis is a chronic systemic inflammatory disease of undetermined etiology. Rheumatoid arthritis is primarily considered a disease of joint but abnormal systemic immune response produce a variety of extra-articular manifestation. Rheumatoid Arthritis (RA) is associated with various neurological manifestations including nerve compression by synovial proliferation, sensory or sensorimotor neuropathies causing neurologic symptom. This study aims to assess peripheral nerve involvement on conduction in rheumatoid arthritis. Methods: 100 patients and healthy controls were included in this study. Rheumatoid arthritis patients diagnosed at the Department of Medicine in VIMSAR during the time period of November 2016-May 2017 were included in the study. Nerve conduction of median, ulnar (motor), posterior tibial and common personal nerves and surely nerves were studied for all healthy controls and patients. Results: In this study, peripheral neuropathy was detected in 54 patients; Mononeuritis simplex was the commonest lesion and detected in 36 out of the 54 patients. Mon neuritis multiplex was detected in 11 and symmetrical polyneuropathy found in 7 patients. The entrapment neuropathy was found in 25 patients, affecting the median in 13, posterior tibial 8 and ulnar 4. So, the axonopathy (mainly due to vasculitis) and local demyelination (mainly due to entrapment) were the common types of nerve injury seen in rheumatoid arthritis. Conclusion: Neurogenic lesions were detected in patients with rheumatoid arthritis without neurological symptoms. So, nerve conduction study are recommended in routine examination to diagnose early neuropathy in RA patients.