Not all neuropathy in diabetes is of diabetic etiology: differential diagnosis of diabetic neuropathy.
Diabetic peripheral neuropathy is the most common peripheral neuropathy in the developed world; however, not all patients with diabetes and peripheral nerve disease have a peripheral neuropathy caused by diabetes. Several (although not all) studies have drawn attention to the presence of other potential causes of a neuropathy in individuals with diabetes; 10% to 50% of individuals with diabetes may have an additional potential cause of a peripheral neuropathy and some may have more than one cause. Neurotoxic medications, alcohol abuse, vitamin B(12) deficiency, renal disease, chronic inflammatory demyelinating neuropathy, inherited neuropathy, and vasculitis are the most common additional potential causes of a peripheral neuropathy in these series. The most common disorders in the differential diagnosis of a generalized diabetic peripheral neuropathy are discussed in this article. Prospective studies to investigate the prevalence of other disorders that might be responsible for a peripheral neuropathy in individuals with diabetes are warranted.
Freeman
Roy
R
Autonomic and Peripheral Nerve Laboratory, Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. rfreeman@bidmc.harvard.edu
D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D006801:Humans