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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Ropper, A. H. Gorson, K. C. |
| Description | Country affiliation: United States Author Affiliation: Gorson KC ( Department of Neurology, St. Elizabeth's Medical Center, 736 Cambridge Street, Boston, MA 02135, USA. kengorson@comcast.net) |
| Abstract | OBJECTIVE: To assess the frequency of additional causes of distal sensory polyneuropathy (DSP) in patients with diabetes mellitus (DM). METHODS: Retrospective review of patients with DM and DSP during a 5 year period. A quantitative sensory score (QSS) was determined at the initial evaluation and extensive laboratory and EMG studies were performed. Patients with one or more potential causes for DSP were compared to those with DM alone. RESULTS: Fifty five patients (53%) had potential additional causes for DSP. These included: neurotoxic medications (seven), alcohol abuse (six), and B12 deficiency and renal disease (four each). The most common laboratory abnormalities were: abnormally low levels of vitamin B6 (11) or B1 (10), monoclonal gammopathy (eight), and hypertriglyceridaemia (eight). Twenty six (25%) subjects had more than one additional cause. Nine (9%) had three or more demyelinating features on EMG. There was a trend toward a lower QSS score (p = 0.05) and reduced mean amplitude of the sensory potentials in those with additional causes. Those with additional causes more often had upper limb sensory symptoms (p = 0.001) and sensory findings (p = 0.003). CONCLUSION: There was a high frequency of additional sources of DSP in patients with DM. These patients more often had sensory symptoms and findings in the hands. Tests that may be useful in the evaluation of DSP in diabetic patients include measures of vitamins B1, B6, B12, serum triglycerides, and immunofixation. |
| ISSN | 00223050 |
| e-ISSN | 1468330X |
| Journal | Journal of Neurology, Neurosurgery & Psychiatry |
| Issue Number | 3 |
| Volume Number | 77 |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Date | 2006-03-01 |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Diabetic Neuropathies Etiology Sensation Disorders Causality Cross-sectional Studies Epidemiology Leg Retrospective Studies Risk Factors Discipline Neurology Discipline Neurosurgery Discipline Psychiatry |
| Content Type | Text |
| Resource Type | Article |
| Subject | Neurology (clinical) Surgery Psychiatry and Mental Health |
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