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Endocrinology
Published in Fazal-I-Akbar Danish, Essential Lists of Differential Diagnoses for MRCP with diagnostic hints, 2017
Diabetic neuropathy:1 Polyneuropathy: bilaterally symmetrical, glove and stocking distribution, mixed (mainly sensory), peripheral neuropathy.2 Mononeuropathy: 3rd and 6th cranial nerves; ulnar, median, sciatic or common peroneal nerves.3 Autonomic neuropathy:15 postural hypotension; gastroparesis; nocturnal diarrhoea; constipation; faecal/urinary incontinence; impotence.4 Diabetic amyotrophy: painful weakness and wasting of quadriceps muscle.
Diabetic Neuropathy
Published in Jack L. Leahy, Nathaniel G. Clark, William T. Cefalu, Medical Management of Diabetes Mellitus, 2000
Proximal motor neuropathy of the lower extremity in diabetic patients has been described under the term of diabetic amyotrophy. It occurs in 0.3-1.0% of diabetics and is more common in type II diabetes (8). Diabetic amyotrophy occurs under circumstances similar to diabetic truncal neuropathy or radiculopathy (i.e., in the setting of weight loss, poor appetite, and over a wide range of diabetic severity, including mild disease (9). The disease presents over days to weeks with severe, deep-aching pain in the back, hip, groin, and anterior thigh area. This is soon followed by weakness and wasting in the iliopsoas, quadriceps, and adductors of the thigh and, less frequently, in the glutei, hamstrings, and gastrocnemius muscles. Usually, the knee reflex is lost or markedly reduced. Although some authors have reported weakness of only the quadriceps muscles, close examination usually discloses weakness in the hip flexors and adductors. Electrodiagnostic testing typically shows denervation in muscles innervated by the lumbar and sometimes the sacral plexus. The paraspinal muscles may also be affected, implying that diabetic amyotrophy in some patients may reflect any underlying polyradiculopathy, rather than a lumbosacral plexopathy. Fortunately, the prognosis for recovery is good with approximately 60% of patients making a substantial improvement within 30 months (10). Usually pain resolves first, later followed by improvement in motor function. Subramony and Wilbourn have reported that more than half of patients with diabetic amyotrophy have an underlying distal symmetrical polyneuropathy (10). A peculiar and unexplained phenomena in diabetic amyotrophy is the finding of a Babiński sign in approximately 50% of patients on the same side as the weakness and in the absence of other upper motor features. Some authors have reported relapses in approximately 20% of cases of diabetic amyotrophy.
Diabetic lumbosacral plexopathy: an unpredictable clinical entity
Published in Disability and Rehabilitation, 2023
Muhammad Faraz Jeddi, Roger Zebaze, Isabelle Urbano, Sarah Skinner, Vinamra Jain, Marc Budge
The prevalence of diabetes mellitus was estimated to be 9.3% (463 million people) worldwide in 2019. This is expected to rise to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045 [1]. Amongst neurological complications, neuropathy affects as many as 50% of patients with type 1 and type 2 diabetic mellitus (DM) [1]. Diabetic plexopathy, also referred to as diabetic amyotrophy, is a distinct, rare, and disabling form of neurological complications affecting about 1% of the diabetic population [2,3].
Docetaxel-induced acute myositis: a case report with review of literature
Published in Journal of Chemotherapy, 2021
Sariya Wongsaengsak, Miguel Quirch, Somedeb Ball, Anita Sultan, Nusrat Jahan, Mohamed Elmassry, Shabnam Rehman
In uncontrolled diabetes patients, another consideration is diabetic amyotrophy, where in patients present as progressive proximal muscle weakness in one leg associated with pain. In this condition, the muscle enzymes will not elevate, and the recovery phase may take months with or without long term deficit.