Reports of leptospirosis-associated, immune-mediated manifestations ranging from mononeuritis
and Guillain-Barrelike syndromes to postinfectious autoimmune epilepsy (3,15) raise the question of whether Leptospira infections might precipitate or aggravate autoimmunity.
Late neuroborreliosis is much rarer than early disease and presents with clinical pictures regarding central nervous system involvement such as progressive encephalitis, myelitis and encephalomyelitis or peripheral nervous system involvement such as mononeuritis
or polyneuritis (3).
 Motor and sensory neurotoxic effects of cnidarian venoms have been reported in several cases of mononeuritis
multiplex produced by different jellyfish  Few reports of Guillain-Barre syndrome and dysphonia following jellyfish stings have also been reported.
(13) In this case, cyclophosphamide was added because of gastrointestinal involvement and progressive and disabling confluent mononeuritis
Peripheral nerve involvement can occur in PAN, which usually presents as subacute or chronic mononeuritis
multiplex or confluent neuropathy.
As per literature, kidneys are more involved in MPA affecting almost 100% of patients while 80% of GPA and 40% of EGPA patients are known to manifest renal symptoms.4,17 Peripheral neuropathy has been reported to manifest predominantly in EGPA patients observed in 76% of patients compared to GPA and MPA (51% and 37% respectively).17 Consistent with this finding, we found that our EGPA patients were more likely to have neurological manifestations (mononeuritis
multiplex and sensor motor-polyneuropathy) (44.4%) compared to GPA and MPA patients (8.7% and 0% respectively).
Our study is limited by a lack of cryoglobulinemia testing (due to technical reasons), which is an independent factor of sensorimotor neuropathy and mononeuritis
Extrahepatic manifestations may include urticarial and maculopapular rash, acute kidney injury, autoimmune hemolytic anemia, aplastic anemia, acute pancreatitis, mononeuritis
, reactive arthritis, Guillain-Barre syndrome and pleural or pericardial effusion, glomerulonephritis, polyarteritis nodosa, cryoglobulinemia, and thrombocytopenia [4, 5].
Meningitis, sensory and motor radiculoneuropathies like mononeuritis
multiplex, and meningoencephalitis [2, 4, 5] may present in LNB; strokes, intracranial hemorrhages, and sinus thrombosis are rare but possible complications in LNB .
Lawrence, "Multiple myeloma masquerading as severe seropositive rheumatoid arthritis with subcutaneous nodules and mononeuritis
multiplex," International Journal of Rheumatic Diseases, vol.
However Guillain-Barre syndrome, mononeuritis
multiplex, and autonomic neuropathy could also occur (1,2,3,4,5).
Thus, literature reports on facial palsy, when referring to mononeuritis
caused by the microorganism Borrelia burgdorferi, investigate and compare facial neuroborreliosis in relation to IFP results.