Diabetic Neuropathy Part 2: Proximal and Asymmetric Phenotypes

Diabetic neuropathy is the most common cause of peripheral neuropathy, with distal symmetric polyneuropathy (DSPN) being the most common form. There are other, less common subtypes that have been described since the 1800s. Unlike DSPN, these subtypes can be asymmetric and affect proximal regions. They include lumbosacral and cervical radiculoplexus neuropathy, thoracic radiculopathy, and cranial and entrapment mononeuropathies. Several theories have been proposed to explain the development of these neuropathies. In most cases, spontaneous recovery occurs, and treatment typically focuses on symptom management and glycemic control. Although immunotherapies have been explored for some of these conditions, their use remains controversial.