To study the characteristics and long-term outcomes of vasculitic neuropathy and to identify clinical and treatment factors associated with neurological improvement.

Patients with vasculitic neuropathy (VN) suffer from delay in diagnosis and, as a result, significant disability. Furthermore, studies looking at the characteristics and long-term outcomes of patients with VN are lacking.

Retrospective chart review of patients with VN seen by a single neurologist between January 2021 and June 2025.

There were 85 patients with VN. Of 85 patients with VN, 68 had complete follow-up data (mean age 65.2 ± 13.1 years, 24% female).  Systemic vasculitis included  ANCA-associated (n=15, 22%), cryoglobulinemic (n=10, 15%), and PAN (n=5, 7%). Non-systemic vasculitis included isolated peripheral nerve vasculitis (n=18, 26%) and diabetic plexopathy (n=14, 21%). Duration of follow-up was 22.6 ± 22.5 months (for the total group). Overall, NIS improved from 28.8 ± 22.8 at baseline to 24.6 ± 21.5 at follow-up (mean change -4.2 ± 13.7). 56% of patients demonstrated neurologic improvement, and 44% had no neurologic improvement. Neuropathy pattern differed significantly between outcome groups (p=0.014). 42% of improved patients had multiple mononeuropathies compared to 10% of non-improved patients. Diagnostic delay was shorter in improved patients (median 5.0 vs. 12.0 months, p=0.012). On multivariate logistic regression, multiple mononeuropathies was an independent predictor of neurological improvement (adjusted OR 6.80, 95% CI 1.91–33.21, p=0.007), after adjusting for diagnostic delay (OR 0.99, p=0.227) and baseline NIS (OR 1.04 per 2 points, p=0.100).

Majority patients had neurologic improvement. A shorter diagnostic delay was associated with greater neurological improvement. Multiple monotherapies were a strong predictor of neurological improvement after adjusting for diagnostic delay and baseline disease severity.