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Subacute diabetic proximal neuropathy

M K Pascoe1, P A Low, A J Windebank

  • 1Department of Neurology, Mayo clinic Rochester, Minnesota 55905, USA.

Mayo Clinic Proceedings
|December 31, 1997
PubMed
Summary

Subacute diabetic proximal neuropathy is a severe variant of lumbosacral radiculoplexopathy. While immunotherapy may offer some benefit in severe cases, most patients experience incomplete, self-limiting improvement.

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Area of Science:

  • Neurology
  • Endocrinology
  • Immunology

Background:

  • Subacute diabetic proximal neuropathy is a severe variant of bilateral lumbosacral radiculoplexopathy.
  • This condition presents with proximal weakness, autonomic failure, and often demyelination with axonal degeneration.

Observation:

  • 44 patients with diabetes and subacute proximal neuropathy were identified between 1983-1995.
  • Clinical features included proximal weakness, reduced reflexes, weight loss, autonomic failure, and elevated CSF protein.
  • Nerve biopsy showed demyelination, less commonly with inflammation.

Findings:

  • Of 12 treated patients, 9 improved; of 29 untreated patients, 17 improved slowly.
  • Improvement was generally incomplete.
  • The condition appears monophasic and self-limiting, differing from chronic inflammatory demyelinating polyradiculoneuropathy.
Keywords:
NASA Discipline CardiopulmonaryNon-NASA Center

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Implications:

  • The efficacy of immunotherapy remains unproven but may be considered for severe or painful cases.
  • Subacute diabetic proximal neuropathy is a distinct entity with potential immune-mediated features.
  • Further research is needed to clarify the role of immunotherapy and the underlying pathophysiology.