Diabetic Amyotrophy

Epineurial microvasculitis in proximal diabetic neuropathy

“…Garland [20] commented that this syndrome was potentially fully reversible and such has been the experience of many authors. A 5-year retrospective review by Coppack and Watkins [ 13] revealed no significant residual motor deficit.…”

“…Garland and Taverner [23] focused attention on the syndrome as a separate entity, initially referring to it as diabetic myelopathy, as some of their patients had extensor plantar responses. Later, Garland [20][21][22] employed the noncommittal title `diabetic amyotrophy', as it was not considered that the underlying pathology was satisfactorily established. Subsequently, electrodiagnostic [ 12,24,27] and neuropathological [32] studies demonstrated that the syndrome represents a proximal motor neuropathy, frequently referred to as diabetic femoral neuropathy [9,13,25].…”

A Family with Kugelberg-Welander Syndrome

“…R ecen tly in a s tu d y dealing w ith the biochem ical changes in K -W syn d ro m e tw o ad d itio n al cases w ith d iabetic glucose tolerance curves were m entioned [5]. A lthough it is know n th a t m y elo p ath y m ay occur in d iab etics [4,7,10], we do not believe th a t these cases belong to the c a teg o ry o f d iab etic m y elo p ath y because this condition is c h a ra c ter ized b y asy m m etric m u scu lar findings, affects m ainly the lower lim bs and is usually associated w ith severe pains. It seem s th a t fu rth e r in v estig atio n is needed in o rd er to clarify a possible association of diab etes w ith the K -W syndrom e.…”

Spinal Stenosis

“…The main toxic effect of prolonged hyperglycaemia is to produce segmental demyelinization along motor and sensory fibres. This produces the following syndromes: symmetrical distal motor-sensory neuropathy; entrapment neuropathy, such as carpal, tarsal or cubital tunnel compression; mononeuritis multiplex; autonomic neuropathy, myelopathy (Garland 1955); radiculopathy (Child & Yates 1978).…”