Myelopathy as a complication of diabetes mellitus

Clinical signs of spinal cord involvement in diabetes mellitus have gained very little attention in the past four decades. On the other hand many pathological studies have shown spinal cord lesions in diabetic patients. We report 12 diabetic patients with clinical signs of myelopathy which, per exclusion, could be explained only as related to diabetes mellitus. Posterior column lesions were more common than corticospinal tract involvement. All our patients had combined peripheral sensory polyneuropathy with myelopathic signs. The combination of peripheral neuropathy, disturbed sense of position and/or vibration with pyramidal signs is highly suggestive of diabetic myelopathy with polyneuropathy. Even though myelopathy is not common in diabetic patients, it is one of the most debilitating neurological complications of diabetes mellitus. We believe that there is enough pathological and clinical evidence to accept the concept of diabetic myelopathy, especially with its prognostic and rehabilitative implications.