Giant cell arteritis and peripheral neuropathy: a report of 2 cases and review of the literature

Giant cell arteritis (GCA) is a systemic vasculitis primarily affecting large and medium sized vessels. While the disease may present with blindness or other signs of extracranial vasculitis, symptoms referable to the peripheral nervous system are uncommon. We describe 2 patients with biopsy proven GCA who simultaneously developed peripheral neurologic lesions. The first developed a mononeuritis multiplex superimposed on a diffuse, primarily sensory and distal polyneuropathy; the second, a symmetric, primarily motor and distal polyneuropathy. We review the published experience of GCA with peripheral nerve involvement and discuss a possible pathophysiologic basis for its occurrence.