Monday, September 26, 2016

Diabetic polyradiculopathy

Diabetic polyradiculopathy is characterized by severe pain in the distribution of one or more nerve roots. Diabetic polyradiculopathy usually resolves over 6–12 months.

Pain over the chest or abdomen may be due to intercostal or truncal radiculopathy. It is more common in men than women and typically occurs with a peak incidence in the sixth decade in patients with type 2 diabetes, usually after a period of poorly controlled hyperglycemia.

Anorexia and substantial weight loss usually occur before or during the syndrome. Blood glucose may normalize after weight loss, which can confuse the picture.

Sensory symptoms may be accompanied by muscle weakness. Severe weakness accompanied by atrophy of the quadriceps muscle is seen on neurologic examination along with occasional weakness of other L3 and L4 innervated muscles. Patients with involvement of the lumbar plexus may be present with thigh or hip pain and weakness of the hip flexors to extensors.

Of the forms of diabetic polyradiculopathy, diabetic thoracic radiculopathy is the most common. Although it has been well recognized for years that thoracic or abdominal pain can be a manifestation of diabetic neuropathy, this entity has been relatively well delineated only since the 1980s.
Diabetic polyradiculopathy

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