Primary polyarteritis nodosa presenting as acute symmetric quadriplegia

Ne report a case of peripheral neuropathy presenting as acute symmetric are flexic quadriplegia in the setting of a well-defined clinical, histopatholo gic, and angiographic diagnosis of classic polyarteritis nodosa. While it i s usually easy to recognize the typical clinical presentation of necrotizin g angiopathy-induced peripheral neuropathy as a mononeuritis multiplex or a distal polyneuropathy in association with a collagen vascular disease, cli nicians must be equally sensitive to a number of more challenging possibili ties. Acute quadriplegia similar to that seen in Guillain-Barre' syndrome c an be secondary to primary classic polyarteritis nodosa and the former may be the chief or even the sole manifestation of the latter.