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Observations on severe ulnar neuropathy in diabetes
W Schady1, B Abuaisha, A J Boulton
1Department of Neurology, Manchester Royal Infirmary, United Kingdom.
Journal of Diabetes and Its Complications
|June 9, 1998
Summary
Severe ulnar neuropathy is common in long-standing diabetes, particularly with systemic complications. This condition, characterized by hand weakness, often involves axonal damage possibly due to ischemia, not just nerve entrapment.
Area of Science:
- Neurology
- Diabetology
- Clinical Neurophysiology
Background:
- Diabetic neuropathy is a common complication.
- Ulnar neuropathy can lead to significant hand dysfunction.
- Severe systemic complications in diabetes may influence neuropathy severity.
Purpose of the Study:
- To investigate the clinical and neurophysiographic features of severe ulnar neuropathy in diabetic patients.
- To determine the prevalence and characteristics of ulnar nerve disease in a diabetes center cohort.
- To explore the relationship between systemic diabetic complications and ulnar neuropathy.
Main Methods:
- Prospective screening of diabetic patients for ulnar nerve disease symptoms.
- Nerve conduction studies (NCS) and electromyography (EMG) on 20 patients.
- Comparison of neurophysiological findings with controls and clinical data.
Main Results:
- Markedly reduced ulnar motor responses and ulnar/median motor ratios observed.
- Absent ulnar sensory action potentials in 30 of 34 affected nerves.
- Advanced denervation in ulnar-innervated hand muscles confirmed by EMG.
Conclusions:
- Motor ulnar neuropathy is frequent in long-standing diabetes, especially with severe systemic issues.
- Nerve entrapment at the elbow occurs in some cases, but axonal damage, potentially ischemic, is common.
- Diabetic patients with hand weakness should be evaluated for severe ulnar neuropathy.