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Diabetic Amyotrophy Mri

Non-diabetic Lumbosacral Radiculoplexus Neuropathy: Natural History, Outcome And Comparison With The Diabetic Variety

Non-diabetic Lumbosacral Radiculoplexus Neuropathy: Natural History, Outcome And Comparison With The Diabetic Variety

Diabetic lumbosacral radiculoplexus neuropathy (DLSRPN) (other names include diabetic amyotrophy) is well recognized, unlike the non-diabetic lumbosacral radiculoplexus neuropathy (LSRPN), which has received less attention. Our objective was to characterize the natural history and outcome of LSRPN and to assess whether it is similar to the diabetic variety in its symptoms, course, electrophysiological features, quantitative sensory and autonomic findings, and the underlying pathophysiology. We studied 57 patients with LSRPN and 33 patients with DLSRPN. We found that the age of onset, course, kind and distribution of symptoms and impairments, laboratory findings and outcomes are essentially alike. Both disorders are a lumbosacral plexus neuropathy associated with weight loss, often beginning focally or asymmetrically in the thigh or leg but usually progressing to involve the initially unaffected segment and the contralateral side. Both have prolonged morbidity due to pain, paralysis, autonomic involvement and sensory loss. In biopsied distal LSRPN nerves, we found changes similar to those found in DLSRPNalterations typical of ischaemic injury and of microvasculitis. The long-term outcome was determined in 42 LSRPN patients: two had become diabetic, seven had relapsed and only three had recovered completely, although all had improved. We conclude that: (i) LSRPN is a subacute, asymmetrical, painful and debilitating neuropathy of the lower limbs associated with weight loss, and we think it is under-recognized; (ii) recovery from the long-term impairments of LSRPN is usually delayed and incomplete and only a small minority of patients develop diabetes mellitus; (iii) LSRPN mirrors the diabetic variety in its clinical features, course, pathological findings (ischaemic injur Continue reading >>

Diabetic Muscle Infarction And Diabetic Dermopathy Two Manifestations Of Uncontrolled Prolong Diabetes Mellitus Presenting With Severe Leg Pain And Leg Skin Lesions

Diabetic Muscle Infarction And Diabetic Dermopathy Two Manifestations Of Uncontrolled Prolong Diabetes Mellitus Presenting With Severe Leg Pain And Leg Skin Lesions

Journal of Diabetes & Metabolic Disorders Diabetic muscle infarction and diabetic dermopathy two manifestations of uncontrolled prolong diabetes mellitus presenting with severe leg pain and leg skin lesions Shenavandeh et al.; licensee BioMed Central Ltd.2014 Diabetic muscular infarction (DMI) is a rare manifestation which can be seen in patients with long-standing diabetes mellitus. Patients usually come with painful swelling of an involved muscle in one extremity. MRI and biopsy histology can help diagnose this condition. Diabetic dermopathy is another manifestation of patients with diabetes. We present a patient with uncontrolled diabetes type 2 presented with pain, swelling, and a palpable tender mass in one leg along with new skin lesions. Biopsy of the skin lesion and T2-weighted MRI of the leg helped differentiate DMI and dermopathy. Diabetic muscle infarctDiabetic dermopathyLeg pain Diabetic muscular infarction (DMI) is a rare condition which has been seen in patients with long-standing diabetes who usually have other complications of poor glycemic control. It has been reported as aseptic myonecrosis, ischemic myonecrosis, and tumoriform focal muscular degeneration. DMI was first described by Angervall and Stener in 1965 [ 1 ]. It presents as an acute onset of painful swelling of the affected muscle. MRI and biopsy histology can help differentiate it with other similar conditions. Even though DMI has been reported for over 45 years, still, less than 200 cases have been reported [ 1 ]. We are presenting a rare manifestation of uncontrolled diabetes type 2 in a patient who came with pain, swelling, and a palpable tender mass in one leg along with new skin lesions. A 57 year old woman, with uncontrolled diabetes type 2 and hypertension, referred to a university ho Continue reading >>

Health Information | Shere Surgery | Diabetic Amyotrophy

Health Information | Shere Surgery | Diabetic Amyotrophy

Diabetic amyotrophy is a nerve disorder which is a complication of diabetes mellitus. It affects the thighs, hips, buttocks and legs, causing pain and muscle wasting. It is also called by several other names, including proximal diabetic neuropathy, lumbosacral radiculoplexus neurophagy and femoral neurophagy. The main features of diabetic amyotrophy are: Weakness of the lower legs, buttocks or hip. Muscle wasting, usually in the front of the thigh, which follows within weeks. Pain, sometimes severe, usually in the front of the thigh but sometimes in the hip, buttock or back. Other features which occur in some (but not all) patients are: Altered sensation and tingling in the thigh, hip or buttock, which tends to be mild in comparison to the pain and weakness. In about half of patients there is a co-existing distal neuropathy, meaning that sensation in the nerves of the lower legs and feet may be separately affected by this condition (which is the most common form of diabetic neuropathy). See separate leaflet called Diabetic Neuropathy for more details . Weight loss occurs in about half of those affected. Symptoms generally begin on one side then spread to the other in a stepwise progression. The condition may come on quickly or more slowly and usually remains asymmetrical (ie the two sides of the body are unequally affected) throughout its course. About half of patients also have distal symmetrical polyneuropathy, so that the sensation in their feet and toes is also affected. The condition tends to last several months but can last up to three years. Over this time it usually recovers, although not always completely. During its course it may be severe enough to necessitate wheelchair use. Pain subsides well before the muscular strength improves. This may take months and Continue reading >>

Phaechromocytoma Presenting As Myopathy

Phaechromocytoma Presenting As Myopathy

Royal Hampshire County Hospital Winchester, Hampshire, UK. A 72-year-old man known to have Churg-Strauss syndrome, Type 2 diabetes mellitus, hypertension and asthma presented with history of polyuria, night sweats, weight loss of 6 kg over 8 weeks and poor mobility. Pulse rate was 88/min and blood pressure 131/74 mmHg. He had generalised muscle wasting with significant proximal myopathy and grade 4/5 power in all four limbs. There was no evidence of vasculitis, arthropathy or other neurological deficit. Blood tests showed urea 10.6 mmol/l and creatinine 113 mol/l. ESR, calcium, liver function, thyroid function tests, antinuclear, antimitochondrial, antismooth muscle, antiparietal cell antibodies, ANCA, myeloperoxidase, PR3 antibodies, CK, tumour markers, serum protein electrophoresis, were normal. HBA1C was 7.1%. He had glycosuria, but no protein or blood in urine. Lumbar puncture showed slightly elevated protein, EMG was suggestive of diabetic amyotrophy and MRI of thoracolumbar spine showed degenerative changes. Serologic tests for tuberculosis, lyme disease and syphilis were negative. CT scan of chest, abdomen and pelvis and subsequent MRI scan showed a 32 cm lesion in the left adrenal gland. Twenty-four hour urine collections on three occasions showed elevated noradrenaline 3.47, 2.80, 3.15 (normal 0.070.48 mol/24 h), adrenalin 0.11, 0.17, 0.14 (normal up to 0.1 mol/24 h) normetadrenalin 9.3, 7.8, 7.8 (normal up to 3 mol/24 h) and metadrenalin 2.2, 1.7, 1.9 (normal upto1.4 mol/l). MIBG scan showed increased uptake suggestive of left adrenal phaeochromocytoma. He was started on phenoxybenzamine, and underwent laproscopic adrenalectomy with histology confirming adrenal phaeochromocytoma. He made good recovery from myopathy, regaining good mobility. His three antihype Continue reading >>

Diabetic Cervical Radiculoplexus Neuropathy: A Distinct Syndrome Expanding The Spectrum Of Diabetic Radiculoplexus Neuropathies

Diabetic Cervical Radiculoplexus Neuropathy: A Distinct Syndrome Expanding The Spectrum Of Diabetic Radiculoplexus Neuropathies

Diabetic cervical radiculoplexus neuropathy: a distinct syndrome expanding the spectrum of diabetic radiculoplexus neuropathies 1 Department of Neurology, Hpital du Sacr-Coeur de Montral, Montral, Qc, H4J 1C5, Canada 2 Department of Neurology, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 2 Department of Neurology, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 2 Department of Neurology, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 3 Department of Radiology and Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 4 Department of Biostatistics, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 2 Department of Neurology, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 2 Department of Neurology, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: 2 Department of Neurology, Mayo Clinic Rochester, Rochester, MN 55905, USA Search for other works by this author on: Brain, Volume 135, Issue 10, 1 October 2012, Pages 30743088, Rami Massie, Michelle L. Mauermann, Nathan P. Staff, Kimberly K. Amrami, Jayawant N. Mandrekar, Peter J. Dyck, Christopher J. Klein, P. James B. Dyck; Diabetic cervical radiculoplexus neuropathy: a distinct syndrome expanding the spectrum of diabetic radiculoplexus neuropathies, Brain, Volume 135, Issue 10, 1 October 2012, Pages 30743088, Diabetic lumbosacral radiculoplexus neuropathy is a subacute painful, asymmetrical lower limb neuropathy due to ischaemic injury and microvasculitis. The occurrence of a cervical diabetic radiculoplexus neuropathy has been postulated. Ou Continue reading >>

[skeletal Muscle Magnetic Resonance Imaging Study In A Patient With Diabeticlumbosacral Radiculoplexus Neuropathy].

[skeletal Muscle Magnetic Resonance Imaging Study In A Patient With Diabeticlumbosacral Radiculoplexus Neuropathy].

[Skeletal muscle magnetic resonance imaging study in a patient with diabeticlumbosacral radiculoplexus neuropathy]. (1)Department of Neurology, Fukushima Medical University. A 63-year-old man with type 2 diabetes mellitus developed deep aching andnumbness in the right hip and lower extremity with rapid body weight loss.Neurological examination revealed weakness of the right hamstrings, tibialisanterior, and peroneus longus muscles with diminished ankle tendon reflex. Wediagnosed him with diabetic lumbosacral radicuoloplexus neuropathy (DLRPN) based on neurological, radiological, and neurophysiological findings. Magneticresonance imaging (MRI) of skeletal muscles showed high intensity signals onT2-weighted images in bilateral hamstrings, adductor magnus and right tensorfasciae latae, and lower leg extensor muscles. The MRI findings suggested muscle edema caused by acute denervation. DLRPN, or diabetic amyotrophy, is known to be caused by ischemic axonal degeneration. Our patient showed good functionalrecovery, and abnormal MRI signals in the involved muscles mostly disappeared in parallel to the clinical course. Distribution of the denervated muscles suggestedthat our patient had either patchy lesions in the lumbosacaral plexus ormononeuropathy multiplex in the nerve branches. The current study highlights the potential of skeletal muscle MRI for clinical evaluation of DLRPN. Continue reading >>

Proximal Diabetic Neuropathy

Proximal Diabetic Neuropathy

Proximal diabetic neuropathy, more commonly known as diabetic amyotrophy, is a nerve disorder that results as a complication of diabetes mellitus. It can affect the thighs, hips, buttocks or lower legs. Proximal diabetic neuropathy is a peripheral nerve disease (diabetic neuropathy) characterized by muscle wasting or weakness, pain, or changes in sensation/numbness of the leg.[1] Diabetic neuropathy is an uncommon complication of diabetes. It is a type of lumbosacral plexopathy, or adverse condition affecting the lumbosacral plexus. There are a number of ways that diabetes damages the nerves, all of which seem to be related to increased blood sugar levels over a long period of time. Proximal diabetic neuropathy is one of four types of diabetic neuropathy.[2] Proximal diabetic neuropathy can occur in type 2 and type 1 diabetes mellitus patients however, it is most commonly found in type 2 diabetics.[3] Proximal neuropathy is the second most common type of diabetic neuropathy and can be resolved with time and treatment.[4] Signs & symptoms[edit] Signs and symptoms of proximal diabetic neuropathy depend on the region of the plexus which is affected. The first symptom is usually pain in the buttocks, hips, thighs or legs. This pain most commonly affects one side of the body and can either start gradually or come on suddenly. This is often followed by variable weakness in the proximal muscles of the lower limbs. These symptoms, although often beginning on one side, can also spread to both sides.[1] Weakness in proximal diabetic neuropathy is caused by denervation of the specific muscles innervated by regions of the plexus affected and can thus these muscles may start exhibiting fasciculations. Note that diabetic amyotrophy is a condition caused by diabetes mellitus, but sepa Continue reading >>

Diabetic And Non-diabetic Lumbosacral Radiculoplexus Neuropathy Bhanushali Mj, Muley Sa Neurol India

Diabetic And Non-diabetic Lumbosacral Radiculoplexus Neuropathy Bhanushali Mj, Muley Sa Neurol India

Background: Lumbosacral radiculoplexus neuropathy (LRPN) originally described in diabetic patients is a distinct clinical condition characterized by debilitating pain, weakness and atrophy most commonly affecting the proximal thigh muscles asymmetrically. The syndrome is usually monophasic and preceded by significant weight loss (at least more than 10 lbs). Though a self-limited condition, recovery is gradual with some residual weakness. Recent advances and research has provided new insights in the pathogenesis and thereby management of this syndrome. In this paper, we review the clinical and diagnostic features as well as discuss recent insights and treatment strategies along with our experience in the management of patients with diabetic and non-diabetic LRPN. Materials and Methods: Literature in English published between 1953 and 2008 was searched in the MEDLINE and Pubmed database, maintained by the US National library of medicine and National institutes of health, using key words of diabetic amyotrophy, lumbosacral radiculoplexus neuropathy, diabetic proximal neuropathy, diabetic radiculopathy and diabetic lumbosacral plexopathy. In addition, literature reported in various textbooks on peripheral neuropathy was reviewed as well. Observation: The diagnosis relies mostly on clinical suspicion and characteristic electromyographic findings. The exact pathogenesis of the illness remains unknown, but there seems to be a component of immune-mediated inflammatory microvasculitis which causes secondary ischemia of the lumbosacral plexus. This has prompted a trial of immunosuppressive agents (like steroids) with an attempt to alter the course of the illness. A few reports have noted that immunosuppression when instituted early in the course of the illness (within three mont Continue reading >>

Diabetic Proximal Neuropathy: Getting At The Root Of The Problemnew Insights Into Diagnosis And Treatment

Diabetic Proximal Neuropathy: Getting At The Root Of The Problemnew Insights Into Diagnosis And Treatment

Diabetic proximal neuropathy is among the most unusual and disabling forms of peripheral neuropathy, causing major suffering among affected individuals. Alternately referred to as lumbosacral radiculoplexus neuropathy, femoral neuropathy, diabetic neuropathic cachexia, or diabetic amyotrophy, the condition is characterized by severe, typically asymmetric leg pain and weakness, predominantly proximal to the muscles around the hip and knee. Although monophasic, diabetic proximal neuropathy is associated with prolonged morbidity due to relentless pain and focal weakness, according to Anthony J. Windebank, MD, Professor of Neurology at the Mayo Clinic College of Medicine in Rochester, MN. Because patients usually improve with time, physicians may underappreciate their pain and suffering. At the peak of their illness, patients are typically confined to a wheelchair and even if mobile, unable to work. Even after recovery, most are left with residual weakness. Complicating the situation, experts told Neurology Today, is that the symptoms often mimic those of other, more common illnesses, which can result in misdiagnosis and unnecessary, inappropriate treatments. Despite numerous studies, the underlying pathogenesis of diabetic proximal neuropathy is still not clearly understood. But research done in the last few years is providing new insights into its natural history, diagnosis, and treatment. Diabetic proximal neuropathy often begins so abruptly that patients can recall the exact day the symptoms began, Dr. Windebank said. The disease develops acutely, reaches a plateau, and gradually improves over time. The initial pain can be sharp or lancinating, or deep or burning, said P. James B. Dyck, MD, Consultant of Neurology and Co-Director of the Peripheral Nerve Laboratory at t Continue reading >>

Diabetic Amyotrophy Showing A Lesion In Lumbar Plexus Mri

Diabetic Amyotrophy Showing A Lesion In Lumbar Plexus Mri

Diabetic Amyotrophy Showing a Lesion in Lumbar Plexus MRI Byeol-A Yoon, MD, Dong-Hyun Shim, MD, Dong-Ho Ha, MD, PhD Department of Neurology, Radiologya, Dong-A University Hospital, Busan, Korea J Korean Neurol Assoc 34(2):165-166, 2016 Received June 15, 2015 Revi se d November 19, 2015 Address for correspondence: Jong Kuk Kim, MD, PhD Department of Neurology Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea Tel: +82-51-240-5266 Fax: +82-51-244-8338 2 119 mg/dL, 277 mg/dL femoral cutaneous nerve) (saphenous nerve) (iliopsoas) (adductor magnus) . (lumbosacral plexus) (psoas muscle) , T1 (diabetic amyotrophy) 1. Dyck PJ, Windebank AJ. Diabetic and nondiabetic lumbosacral radi- culoplexus neuropathies: New insights into pathophysiology and 2. C ianfo ni A, L uiget ti M, M adia F, Co nte A, S avin o G, Co losi mo C, et al. Teaching NeuroImage: MRI of diabetic lumbar plexopathy treated with local steroid injection. Neur ology 2009;72:e32-e33. Fig ure. Lumbosacral plexus magnetic resonance imaging of patient on admission (A, B, C). Coronal T2-weighted image showed increased signal intensity on right L3, L4 roots and psoas muscle (A). The signal intensity change was more prominent in fat suppression T2-weighted image (B). Contrast-enhanced fat suppression T1-weighted image revealed abnormal enhancement lesion in the same area (C). Follow up magnetic resonance images after treatment with steroid and diabetes medication for 3 months (D, E, F). Abnormal signal intensity lesion was marked improved on T2-weighted image (D) and fat suppression T2-weighted image (E). Enhanced lesion was disappeared on contrast-enhanced fat suppression T1-weighted Continue reading >>

Think Pyomyositis! - Practical Diabetespractical Diabetes

Think Pyomyositis! - Practical Diabetespractical Diabetes

Ann Nainan, Hind Shagali, Balasubramanian Srinivasan, Ammar Tarik November 28, 2017 Vol 34.9 November / December 2017 Uncontrolled diabetes is associated with increased risk of infections. An uncommon but rather serious infection is pyomyositis which is a purulent infection of the skeletal muscle. Delay in recognition and diagnosis can lead to serious complications. We report the case of a 44-year-old male patient with a background of uncontrolled diabetes who presented with bilateral thigh pain and progressive leg weakness over three weeks. He had no other comorbidities and he denied any recent trauma or foreign travel. On examination he had multiple hard lumps in both thighs and blood results showed leucocytosis and raised inflammatory markers. Magnetic resonance imaging (MRI) showed multiple bilateral thigh abscesses. The diagnosis of pyomyositis was made and drains were inserted into the two largest abscesses. Simultaneously, he was started on antibiotics based on the drained fluid culture and sensitivity. On drainage of the abscesses and completion of eight weeks of antibiotics, he gradually regained the lower limbs power and the thigh pain resolved. His recovery was aided by the better control of diabetes with insulin therapy. Pyomyositis is mainly encountered in tropical areas. Non-tropical pyomyositis is more common in immunocompromised patients and patients with uncontrolled diabetes. It requires a high index of suspicion because of its indolent presentation that may mimic other pathologies like cellulitis, diabetic amyotrophy, septic arthritis and deep vein thrombosis. MRI is the best diagnostic tool to differentiate pyomyositis from these disorders. Early diagnosis and intervention with drainage of the abscesses and appropriate antibiotics prevent serious co Continue reading >>

Case Report: An Unusual Presentation Of Diabetic Amyotrophy: Myoclonus

Case Report: An Unusual Presentation Of Diabetic Amyotrophy: Myoclonus

Mixed demyelinating and axonal neuropathy. Note the prolonged F-wave latency (41.2 ms), which is in the demyelinating range in the right median nerve. The following investigations were either normal or negative: routine blood count, erythrocyte sedimentation rate, renal, thyroid and liver function tests, serum electrophoresis, vitamin B12, folate, autoimmune, vasculitis and paraneoplastic screen. Differential diagnosis considered at presentation includes infiltrative, compressive and infective causes of polyradiculopathy, structural disc diseases and chronic demyelinating neuropathies. Clinical suspicion and electrophysiological findings were consistent with a diagnosis of diabetic amyotrophy. He was treated with oral levetiracetam and a 3-day course of intravenous steroids (methylprednisolone) followed by a reducing dose of oral steroids. He also underwent physiotherapy. There was dramatic improvement within a few weeks of starting steroids, which was gradually tapered over a 3-month period. Repeat CSF examination at 4 weeks showed protein of 0.75 g/l. At a 2 -month follow-up appointment, he was independently ambulant and his myoclonic jerks had resolved completely. Diabetic amyotrophy, also known as diabetic proximal neuropathy or diabetic lumbosacral radiculoplexus neuropathy, is distinctive and among the most disabling forms of diabetic neuropathy. 1 It affects approximately 1% of the diabetic population. 2 The affected patients are usually middle-to-old aged with the mean age being 62 years. 3 In contrast to other forms of polyradiculoneuropathies like chronic inflammatory demyelinating neuropathy, diabetic amyotrophy has more restricted distribution and is usually considered as a self-limiting illness. 4 In our case, symptoms and signs were predominantly limited Continue reading >>

Diabetic Amyotrophy Showing A Lesion In Lumbar Plexus Mri

Diabetic Amyotrophy Showing A Lesion In Lumbar Plexus Mri

Diabetic Amyotrophy Showing a Lesion in Lumbar Plexus MRI J Korean Neurol Assoc 2016; 34(2): 165-166. Diabetic Amyotrophy Showing a Lesion in Lumbar Plexus MRI Department of Neurology, Dong-A University Hospital, Busan, Korea aDepartment of Radiology, Dong-A University Hospital, Busan, Korea Address for correspondence: Jong Kuk Kim, MD, PhD Department of Neurology Dong-A University Hospital, 26 Daesingongwon-ro, Seo-gu, Busan 49201, Korea Tel: +82-51-240-5266 Fax: +82-51-244-8338 E-mail: [email protected] Received June 15, 2015 Revised November 19, 2015 Accepted November 19, 2015 Copyright 2016 Korean Neurological Association 56 2 . 3 . 2 119 mg/dL, 277 mg/dL . (medial femoral cutaneous nerve) (saphenous nerve) (rectus femoris) (iliopsoas) (adductor magnus) . (lumbosacral plexus) T2 3 (psoas muscle) , T1 ( Fig. A - C ). (diabetic amyotrophy) [ 1 ]. 3 T2 , T1 ( Fig. D - F ). , [ 2 ]. 1. Dyck PJ, Windebank AJ. Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: New insights into pathophysiology and treatment. Muscle Nerve 2002;25:477-491. 2. Cianfoni A, Luigetti M, Madia F, Conte A, Savino G, Colosimo C, et al. Teaching NeuroImage: MRI of diabetic lumbar plexopathy treated with local steroid injection. Neurology 2009;72:e32-e33. Lumbosacral plexus magnetic resonance imaging of patient on admission (A, B, C). Coronal T2-weighted image showed increased signal intensity on right L3, L4 roots and psoas muscle (A). The signal intensity change was more prominent in fat suppression T2-weighted image (B). Contrast-enhanced fat suppression T1-weighted image revealed abnormal enhancement lesion in the same area (C). Follow up magnetic resonance images after treatment with steroid and diabetes medication for 3 months (D, E, F). Abnormal signal intensity lesion was mar Continue reading >>

Femoral Neuropathy | Diabetic Amyotrophy | Brooklyn Ny

Femoral Neuropathy | Diabetic Amyotrophy | Brooklyn Ny

Femoral neuropathy is a femoral nerve damage condition which is more common in people with type 2 diabetes and older adults. Also known as diabetic amyotrophy or proximal neuropathy, this nerve condition can lead to difficulties moving around. The femoral nerve is the major nerve that serves the tissues of the thigh and leg, including the muscles and skin. Poor blood sugar control is the major risk factor to this nerve damage. A leading healthcare center in Brooklyn, NY, HealthQuest offers femoral neuropathy treatment that can help to treat the underlying cause of this nerve damage and thus improve the patients quality of life. Other symptoms associated with the disorder include abnormal sensations in the legs such as numbness or tingling in any part of the leg, and difficulty extending the knee. Early diagnosis and treatment is the best option for controlling symptoms and preventing more-severe problems. A comprehensive examination will be carried out for accurate diagnosis. Electromyography (EMG), nerve conduction studies, MRI or CT scan may be recommended to review the conditions. While an MRI scan looks for tumors, growths, or any other masses in the area of the femoral nerve that causes compression on the nerve, a CT scan, using cross-sectional x-rays, can also look for vascular or bone growths. Based on the analysis, our physicians create a personalized treatment plan that can improve the symptoms. Treatment programs include: Medications - Diabetic neuropathy pain can sometimes be managed with certain medications such as antidepressants, and opiates or opiate like drugs. Physical Therapy - Physical therapy exercises help to restore the nerves in the legs. It can also help to build up the strength in the leg muscles again, thus reduce pain and regain mobility. Chi Continue reading >>

Diabetic Amyotrophy | Doctor | Patient

Diabetic Amyotrophy | Doctor | Patient

Professional Reference articles are written by UK doctors and are based on research evidence, UK and European Guidelines. They are designed for health professionals to use. You may find the Diabetic Amyotrophy article more useful, or one of our other health articles . Synonyms: Bruns-Garland syndrome, asymmetrical proximal diabetic neuropathy, lumbosacral plexopathy and diabetic lumbosacral radiculoplexus neuropathy Diabetic amyotrophy is a diabetic proximal neuropathy. See also separate Diabetic Neuropathy article. Most (but not all) affected patients have type 2 diabetes.[ 1 ] Diabetic amyotrophy is believed to result from a multifocal immune-mediated microvasculitis, ie an immune abnormality involving vasculitic changes, microvascular insufficiency and ischaemia followed by axonal degeneration and demyelination.[ 4 ] Nerve biopsy shows multifocal nerve fibre loss suggesting ischaemic injury and perivascular infiltrate. It predominantly affects motor nerves of the lumbosacral plexus, particularly the femoral nerve, although autonomic and sensory nerves are also involved.[ 4 , 5 ] The condition is a diffuse axonal neuropathy. It falls within a spectrum of different neuropathic syndromes caused by or associated with diabetes. Their aetiology includes metabolic, compressive and inflammatory/immunological mechanisms. They are discussed further in the separate Diabetic Neuropathy articleand include:[ 2 , 6 ] Generalised symmetrical polyneuropathies. Diabetic autonomic neuropathy, present to some degree in up to 75% of patients with type 2 diabetes. Focal neuropathies: mononeuropathies and entrapment syndromes - eg, median nerve neuropathy. Diffuse neuropathies: much less common but significant due to their severity and morbidity: Axonal (mainly proximal - eg, diabetic amy Continue reading >>

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