Ischaemic monomelic neuropathy (IMN) following vascular access surgery for haemodialysis: an under-recognized complication in non-diabetics

Ischaemic monomelic neuropathy (IMN) is an infrequently recognized type of neuropathy, produced after acute arterial occlusion or reduced blood flow to an extremity. In the upper limb, it usually occurs after vascular access surgery for haemodialysis. IMN has been reported largely in diabetics with peripheral neuropathy and atherosclerotic vascular disease. We report a case of IMN following arteriovenous (AV) fistula formation in a patient with advanced chronic renal failure, who did not have diabetes mellitus and symptoms of peripheral neuropathy or features of atherosclerotic vascular disease. Symptoms improved immediately after the distal revascularization and interval ligation procedure to the AV fistula.