Treatable lumbosacral polyradiculitis masquerading as diabetic amyotrophy.
Patients with diabetic amyotrophy may have an inflammatory vasculopathy and may obtain reversal of neurological deficits with immunosuppression. We present a patient with NIDDM, subacute onset of painful asymmetric polyradiculopathy, and unilateral enhancement of lumbar nerve roots on MRI. Clinical improvement and resolution of nerve root enhancement occurred with immunosuppression. We suggest, therefore, that nerve biopsy and gadolinum-enhanced lumbosacral MRI be performed in all patients presenting with diabetic amyotrophy. If nerve root enhancement is present or if nerve biopsy shows perivascular infiltrates, we recommend a trial of immunosuppression.
O'Neill
B J
BJ
Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Flanders
A E
AE
Escandon
S L
SL
Tahmoush
A J
AJ
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2; D003929:Diabetic Neuropathies / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004576:Electromyography; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology; D011128:Polyradiculopathy / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy*; D013497:Sural Nerve / Q000473:pathology
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone