Peripheral neuropathies after arthropod stings not due to Lyme disease: a report of five cases and review of the literature

Neurology. 1993 Aug;43(8):1483-8. doi: 10.1212/wnl.43.8.1483.

Abstract

Five patients developed neurologic symptoms a few hours to 2 months after being stung by a non-hooking arthropod with immediate cutaneous reaction. The patients had no clinical or serologic evidence for Lyme borreliosis and rickettsial disease. Clinical and electrophysiologic findings were consistent with a mixed axonal and demyelinating mononeuropathy, a monomelic multiple mononeuropathy, a mononeuropathy multiplex, a radiculoneuritis, and a distal symmetric polyneuropathy. Muscle and nerve biopsies showed lymphoplasmacytic small-vessel vasculitis in all patients, and wallerian degeneration in three. These patients, and 17 others from the literature, indicate a spectrum of peripheral neuropathies occurring after insect and spider stings.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Animals
  • Arthropods*
  • Bites and Stings / microbiology
  • Borrelia burgdorferi Group / isolation & purification
  • Female
  • Humans
  • Insect Bites and Stings / complications*
  • Lyme Disease / complications
  • Lyme Disease / microbiology
  • Male
  • Middle Aged
  • Neural Conduction
  • Peripheral Nervous System Diseases / etiology*
  • Peripheral Nervous System Diseases / physiopathology