Focal and multifocal diabetic neuropathies

Saïd, Gérard

doi:10.1590/s0004-282x2007000700037

Cited by 34 publications

(30 citation statements)

References 30 publications

(29 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…DPNP'nin nadir görülen proksimal asimetrik PNP alt tiplerinden biridir. Tip 2 de % 1.1, Tip 1 de %0.3 oranında ve [3] orta veya ileri yaş hastalarda daha sık görülür [4,6,9,10]. Son yıllara kadar DM'ye bağlı nöropatide iskemi ve metabolik kontrol bozukluğu iki ayrı neden olarak gösteril-miştir.…”

Section: Discussionunclassified

See 1 more Smart Citation

Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

Kurt¹

2014

Dicle Med J

View full text Add to dashboard Cite

Diabetic amyotrophy is a relatively infrequent complication of diabetes mellitus is most often characterized by weakness of unilateral lower limb and pain. Clinical differentiation from lumbar disc herniation may be difficult. ıt was hereby presented; 64 year old male patient who has 15 year old history of diabetes mellitus and lumbar discopathy previously diagnosed. He had weakness of unilateral lower limb and pain. Patient was admitted right thigh pain and weakness of proximal lower limb muscle. The physical examination, magnetic resonance imaging and electromyographic examination of the patient was consistent with the diagnosis of diabetic amyotrophy. When diabetic amyotrophy and lumbar disc herniaton coexist as a pain source, which disease responsible from pain should be detected well and treatments should be arrenged according to responsible disease. Thus, unnecessary surgeries can be avoided.Key words: Diabetes mellitus, lumbar disc herniation, diabetic amyotrophy ÖZET Diyabetin nadir bir komplikasyonu olan diyabetik amiyotrofi genellikle tek taraflı alt ekstremitede proksimal kas güçsüzlüğü ve ağrı ile seyreder. Klinik olarak lomber diskopatiden ayırımı zor olabilir. Bu olguda daha önce lomber diskopati tanısı konmuş ve 15 yıllık diyabetes mellitusu olan erkek hasta sunulmuştur. Hasta sağ uyluk bölgesinde ağrı, sağ alt ekstemite kas güçsüzlüğü şika-yeti polikliniğe başvurdu. Hastaya fizik muayene, manyetik rezonans görüntüleme ve elektrofizyolojik çalışmalar sonunda Diabetik amiyotrofi tanısı konulmuştur. Özellikle ağrı nedeni olarak lomber diskopti ve diyabetik amiyotrofi birlikteliğinde hastanın şikayetinin hangi hastalıktan kaynaklandığının iyi belirlenmesi ve tedavinin ona göre düzenlenmesi sağlanmalıdır. Böylece gereksiz cerrahi müdahaleden kaçınılmış olur.Anahtar kelimeler: Diyabet, lomber diskopati, diyabetik amiyotrofi GİRİŞ Diyabetik polinöropati (DPNP) diyabetes mellitusun (DM) sık komplikasyonlarından biridir. Kan glukoz düzeyinin yüksekliği ve hastalık süresi ile ilişkilidir [1,2]. Diyabetik amiyotrofi (DA), DP-NP'nin nadir bir formudur. Alt ekstremite proksimalinde akut veya subakut gelişen genellikle asimetrik güçsüzlük ve atrofi ile karakterizedir [3]. Lomber disk hernili (LDH) hastalarda da benzer şe-kilde tek taraflı veya her iki alt ekstremitede ağrı ve güçsüzlük gelişebilir. Diyabetli hastalar tek taraflı alt ekstremite ağrı ve güçsüzlüğü tariflediğinde DA ve LDH'nın ayırıcı tanısı zor olabilir [4,5,6]. Bu iki hastalığın ayırıcı tanısındaki zorluk sebebiyle hastalara gereksiz LDH cerrahisi uygulanabilir [4].Bu olguda lomber diskopati ve DA birlikteliği olan bir hastanın ayırıcı tanısı ve tedavi yaklaşımla-rı tartışılmıştır. OLGUAltmışdört yaşında 15 yıldır diyabetes mellitusun tanısı olan erkek hasta (A.Ö) 5 ay önce sağ bacağa yayılan bel ağrısı ve ayaklarda uyuşma şikayeti ile polikliniğimize başvurdu. Hastanın muayenesinde ,bel eklem hareket açıklığı; fleksiyonu sonlara doğ-ru ağrılı ve kısıtlı, diğer yönlere ağrılı ama açıktı.

show abstract

Section: Discussionunclassified

“…Diyabetik amiyotrofi (DA), DP-NP'nin nadir bir formudur. Alt ekstremite proksimalinde akut veya subakut gelişen genellikle asimetrik güçsüzlük ve atrofi ile karakterizedir [3]. Lomber disk hernili (LDH) hastalarda da benzer şe-kilde tek taraflı veya her iki alt ekstremitede ağrı ve güçsüzlük gelişebilir.…”

unclassified

Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

Kurt¹

2014

Dicle Med J

View full text Add to dashboard Cite

show abstract

“…It has an immunologic pathophysiology involving both the humoral and the cellular immunologic response, which supports the rationale to the immunotherapy 1,2 . Diabetes mellitus is the most common cause of peripheral neuropathy in industrialized countries and CIPD must be considered in the differential diagnosis of the diabetic somatic neuropathies 3 . However, the distinction of diabetic somatic polyneuropathy from CIDP is not a simple task.…”

Section: Casementioning

confidence: 99%

“…However, the distinction of diabetic somatic polyneuropathy from CIDP is not a simple task. While CIDP progresses in months, with relapses in a third of the cases, in the diabetic neuropathy the course is slower, progressing in years, and usually related to the length of diabetes [1][2][3][4]5 . In addition, the electromyography and nerve conduction studies reveal demyelination with nervous conduction abnormalities, contrary to the axonal pattern of diabetic neuropathy.…”

Section: Casementioning

confidence: 99%

Chronic inflammatory demyelinating polyneuropathy in an adolescent with type 1 diabetes mellitus

Alves

Braid

Públio

2009

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Chronic inflammatory demyelinating polyradiculopathy (CIDP) is an immune-mediated disorder for which specific clinical cerebrospinal fluid (CSF), electrophysiologic and histological criteria have been proposed 1 . CIPD is an uncommon cause of childhood polyneuropathy. Descriptions of children with CIPD are scarce. Therefore, this article intends to report a case about an adolescent with type 1 diabetes mellitus (T1DM) with a satisfactory therapeutic response to immunoglobulin and methylprednisolone.This presentation highlights the importance of investigating diabetic patients, including children, with polyneuropathy in an attempt to identify the ones with demyelinating polyneuropathy, because of the likelihood of these patients to benefit from immumodulatory and/or immunossupressive treatment. CaSeMale, 14 year-old, with a seven year history of T1DM and one year history of diabetic nephropathy. Under insulinotherapy and captopril with unsatisfactory glycemic control. Nine months before the initial evaluation he presented pain, paresthesia and a progressive, symmetric muscular weakness, in both lower limbs. After five months of therapeutic failure under carbamazepine and amytryptiline, he was referred to our service. The initial evaluation showed a mild and symmetric, proximal and distal lower limb weakness (the upper limbs were not affected). The proximal compromise was worse than distal. There were patellar and Achilles tendon hyporeflexia, with absence of Babinski sign. Pain, vibratory and position stimulus modalities were normal, although tactile sensory tests evidenced paresthesias. Anal and vesical sphincter function and muscular tone were preserved.Complete blood count, erythrocyte sedimentation rate, urea, creatinine, electrolytes, AST, ALT, GGT, alkaline phosphatase, prothrombine time, total proteins, albumin, creatinekynase (CK), CK-MB, thyroid function tests, lipid profile and cerebrospinal fluid evaluation were normal.The first electromyography (EMG), done five months after the beginning of the neurologic symptoms (Nihon Khoden Electromyography, 4 channels), evidenced decreased conduction velocities with normal amplitude in the median, ulnar, left fibular and posterior tibial nerves, except in the deep right fibular nerve, where although the amplitude was 75% of the lower limit of the normal range (LLNR), the conduction study was 80% lower than LLNR. The distal motor latencies of the median, left ulnar, superficial fibular and sural nerves were prolonged (above 120% of the normal range). The F waves presented prolonged latencies in the ulnar and posterior tibial nerves. The examination with monopolar needle showed decrease in the recruitment of action potentials of the motor unit.The patient was initially treated with human immunoglobulin (400 mg/Kg/day, IV, 5 days), improving the sensory symptoms for about a month, with subsequent relapse, in smaller intensity. There was not improvement of the lower limb weakness. A second EMG, performed 2 months after therapy with immunoglobulin, evidenced increment...

show abstract

“…, é progressiva e irreversível 3,4 , atingindo até 80% dos diabéticos 5,6 . Estudos anteriores mostram que a NP leva a perda das informações sensoriais cutâneas nos pés, podendo ocasionar transtornos da estrutura osteoarticular dessa região, além de contribuir para modificar a marcha, o equilíbrio estático e dinâmico 7 .…”

unclassified

Equilíbrio estático de indivíduos com neuropatia periférica diabética

2012

View full text Add to dashboard Cite

O diabetes mellitus (DM) é uma das enfermidades crônicas mais diagnosticadas nos últimos anos. A neuropatia diabética periférica (NP) é a complicação mais prevalente dessa doença, atingindo até 80% dos diabéticos, podendo modificar o equilíbrio. Este estudo teve por objetivo comparar o equilíbrio estático de indivíduos diabéticos neuropatas, diabéticos não neuropatas e indivíduos sem DM e averiguar a influência da visão nessa situação. Foram avaliados 30 indivíduos, divididos em três grupos diferentes: GC, 10 não diabéticos (média de idade 55,5±9,72 anos); GD: 10 diabéticos sem NP (54,4±7,76 anos); e GNP, 10 diabéticos com NP (60,4±5,35 anos). Cada indivíduo foi filmado nos planos frontal e sagital, com e sem visão, avaliado quadro a quadro no software Free Video to JPG Converter®, para a seleção dos momentos de maiores oscilações. As imagens foram quantificadas através da Biofotogrametria Computadorizada, utilizando-se o software SAPO. Os dados foram tratados estatisticamente no software Graph Pad Prism (versão 5). Os resultados evidenciam que o grupo GNP apresentou diferenças estatisticamente significantes nas amplitudes de oscilações no plano frontal e sagital, nas condições com e sem visão, quando comparado com os outros grupos (p=0,0001). Mediante os resultados, concluiu-se que a NP influencia negativamente na manutenção do equilíbrio estático, principalmente sem visão.

show abstract

Focal and multifocal diabetic neuropathies

Cited by 34 publications

References 30 publications

Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

Weakness of unilateral lower limb’s proximal muscle; diabetic amyotrophy coexisting with lumbar discopathy: Case report and review of the literature

Chronic inflammatory demyelinating polyneuropathy in an adolescent with type 1 diabetes mellitus

Equilíbrio estático de indivíduos com neuropatia periférica diabética

Contact Info

Product

Resources

About