What are the approach considerations in the workup of polyarteritis nodosa (PAN)?

Updated: Nov 14, 2017
  • Author: Dana Jacobs-Kosmin, MD, FACP; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Evidence of peripheral neuropathy should be sought carefully with history and electromyography (EMG), since it is a common complication of polyarteritis nodosa (PAN), being found in as many as 60% of patients. Mononeuritis multiplex is the most common form of PAN neuropathy, but other forms can be present.

Many neurologic and systemic disorders can present with headache. Pathologic headaches are often difficult to differentiate from benign headaches solely on clinical grounds. Severe, persistent headaches, with or without neurologic deficit, warrant complete neurologic evaluation, including brain-imaging studies.

Even though stroke is a late complication in many cases of PAN, it certainly can occur early. PAN and other vasculitic diseases should be considered in many patients with stroke with multiple foci or a combination of hemorrhage and infarction.

Electroencephalography (EEG) may show nonspecific findings of generalized slow wave activity during periods of encephalopathy or toxic delirium.


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