"Diabetes affects nerves, and you don't need to have severe diabetes to have neuropathy
," explains neurologist Shamsha Doran, MD, UCLA Medical Center, Santa Monica.
Gradual Symptoms Peripheral neuropathy
first affects the longer nerves most distant from the brain and spinal cord, starting in the toes and feet.
"This would significantly reduce the proportion of patients with diabetes who would be falsely identified as having no peripheral neuropathy
and subsequently denied the benefit of beneficial and effective secondary risk factor control," said study coauthor Cynthia Formosa, PhD, of the University of Malta, Msida, and Staffordshire University, Stoke-on-Trent, England, in an interview.
Clinical abnormalities consistent with peripheral neuropathy
were common and were observed in about half (50.5 percent) of those treated with neurotoxic chemotherapy (mean Total Neuropathy
Score increase, 2.1); these abnormalities correlated with lower limb predominant sensory axonal neuropathy
(mean amplitude reduction, 5.8 [micro]V).
These were suggestive of an asymmetrical sensorimotor axonal neuropathy
. Sural nerve biopsy revealed concentric thickening of epineural medium-sized and large arterioles with focal fibrinoid necrosis, transmural inflammation, and uniform axonal loss with focal axonal breakdown consistent with necrotizing vasculitis.
As it progresses, it results into painful neuropathy
. Painful paresthesia of the fingers may progress into a deep-seated ache, which may radiate up to the whole arm.
Vitamin D deficiency itself has been associated particularly with diabetic peripheral neuropathy
[10-12] rather than retinopathy or maculopathy [13, 14].
Telling the two apart is crucially important because diabetic neuropathy
cannot be reversed but CIDP can often be treated extremely effectively, preventing the progression of debilitating symptoms like sensory loss, pain and weakness with impaired movement.
The sural nerve biopsy is less frequently required but may help in the differential diagnosis with other types of neuropathy
Therefore nerve conduction studies should be carried out for the early detection and management of neuropathy
in the diabetic patients.
is a rare entrapment neuropathy
that is not well known in the diagnosis and differential diagnosis of pelvic pain.
Recently an inflammatory etiology was found to be the cause of unexplained postsurgical neuropathy
in a number of cases.