Diabetic asymmetric proximal neuropathy

• Published in: Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova Vol. 117; no. 1; p. 59
• Main Authors: Kotov, S V, Rudakova, I G, Isakova, E V, Belova, Yu A, Volchenkova, T V, Khirbek, M, Stashuk, G A
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) 2017
• Subjects: Adult; Aged; Aged, 80 and over; Analgesics - therapeutic use; Autonomic Nervous System - physiopathology; Blood Glucose; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - epidemiology; Diabetic Neuropathies - diagnosis; Diabetic Neuropathies - drug therapy; Diabetic Neuropathies - epidemiology; Diabetic Neuropathies - physiopathology; Duloxetine Hydrochloride - therapeutic use; Female; Humans; Male; Middle Aged; Neuralgia - diagnosis; Neuralgia - drug therapy; Pregabalin - therapeutic use; Young Adult
• ISSN: 1997-7298
• DOI: 10.17116/jnevro20171171159-62

To study the prevalence, clinical features and treatment of diabetic asymmetric proximal neuropathy (DAPN).
Four hundred and forty-five patients with diabetes mellitus (DM), 257 women and 188 men, mean age 47.6±0.5 years, including 163 patients with DM type I and 282 with DM type II, were examined.
Distal symmetric sensory motor polyneuropathy was found in 62% of the patients, autonomic neuropathy in 25.6%, somatic mononeuropathy in 28.5%, DAPN in 7.9%. DAPN was more frequent in patients with DM type II (9.6), with poor control of glycemia and DM duration more than 5 years. Pain and paresthesia in a zone of innervation of several roots and nerves, amyotrophy that spread beyond the definite myotome were key symptoms of DAPN. The efficacy of double therapy of neuropathic pain (pregabalin and duloxetine) and vitamin B complex was shown. A role of glucocorticoids and normal human immunoglobulin in treatment of DAPN is discussed.