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painless diabetic motor neuropathy
Etiology:
- diabetes mellitus type 2
- median duration of diabetes = 5 years
Epidemiology: rare
Pathology:
- ischemic injury
- microvasculitis
- perineural thickening
- neovascularization
Laboratory:
- HbA1c: often normal, glycemic control tends to be good
- nerve biopsy
Clinical manifestations:
- insidious onset, slow evolution of symptoms
- presenting symptoms may be unilateral
- progression to symmetric distribution
- painless
- upper extremity & lower extremity muscle weakness
- subsacute bilateral foot drop
- later involvement of proximal leg muscles
- lesser involvement of upper extremities
- weight loss is common
- disability tends to be greater than diabetic polyneuropathy
General
diabetic amyotrophy/lumbar polyradiculopathy; diabetic lumbosacral radiculoplexus neuropathy (DLRPN)
References
- Journal Watch, Massachusetts Medical Society, Aug 1, 2011
- Garces-Sanchez M et al
Painless diabetic motor neuropathy: a variant of diabetic
lumbosacral radiculoplexus Neuropathy?K, Norell JE, Dyck PJ.
Ann Neurol. 2011 Jun;69(6):1043-54
PMID: 21425185