Diabetic amyotrophy: a painful radiculoplexus neuropathy

Diabetic lumbosacral radiculoplexus neuropathy is a monophasic syndrome of diffuse pain and weakness that typically affects the lower limbs asymmetrically and is often associated with significant weight loss. Recovery can be prolonged and unpredictable. It is a clinical diagnosis and investigations are performed mainly to exclude other causes. Although it is most likely caused by a microvasculitis, there is no evidence to support using intravenous immunoglobulin or any long-term immunosuppression. Pulsed methylprednisolone may help pain if given within 2-3 months of symptom onset.