Diagnostic Crossroads: To Highlight Diagnostic Confusion with Tongue Atrophy and Fasciculations Can Be a Manifestation of Neuropathy
Abstract: Peripheral neuropathy is a common neurological disorder with diverse etiologies, including metabolic, inflammatory, autoimmune, toxic, and endocrine causes. Among these, vasculitic neuropathy represents an important but potentially treatable cause of subacute to chronic progressive sensorimotor polyneuropathy. It typically results from inflammation of the vasa nervorum, leading to ischemic nerve injury and predominantly axonal degeneration. Clinically, patients may present with painful, asymmetric or symmetric sensorimotor deficits, often associated with systemic inflammatory features. Vasculitic neuropathy may occur as part of systemic autoimmune diseases, including rheumatoid arthritis and other connective tissue disorders, or as a nonsystemic vasculitic neuropathy confined to peripheral nerves. Nerve conduction studies typically show axonal sensorimotor polyneuropathy, and definitive diagnosis is often established by nerve biopsy demonstrating transmural inflammatory infiltrates and vascular changes. Early recognition is crucial, as timely immunosuppressive therapy can significantly alter disease progression and improve functional outcomes. In this case, we present a middle-aged female with hypothyroidism and chronic joint pain who developed progressive painful sensorimotor polyneuropathy with neurogenic atrophy and biopsy-proven vasculitic neuropathy, highlighting the diagnostic crossroads between inflammatory, and other neurogenic mimic etiologies.
Keywords: Vasculitic Neuropathy, Sensorimotor Polyneuropathy, Axonal Degeneration, Nerve Biopsy, Immunosuppressive Therapy
How to Cite?: Dr. Kalpana P, Dr. Alex J, Dr. Anisha Ashraf, Dr. Sethuram, Dr. Y. Kingsly Jebasingh, "Diagnostic Crossroads: To Highlight Diagnostic Confusion with Tongue Atrophy and Fasciculations Can Be a Manifestation of Neuropathy", Volume 15 Issue 10, October 2026, International Journal of Science and Research (IJSR), Pages: 1212-1214, https://www.ijsr.net/getabstract.php?paperid=SR261018212722, DOI: https://dx.doi.org/10.21275/SR261018212722