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NEUROLOGY 1976;26:108
© 1976 American Academy of Neurology

Subacute proximal diabetic neuropathy

IAN R. WILLIAMS, M.B., Ch.B., M.R.C.P. and RICHARD F. MAYER, M.D.

From the Department of Neurology, University of Maryland School of Medicine, Baltimore, Maryland 21201.

The results of clinical, electrophysiologic, and histologic studies in three patients with a type of diabetic peripheral neuropathy, subacute proximal diabetic neuropathy (diabetic amyotrophy), are presented. On the basis of our findings, we suggest that diabetic amyotrophy is a clinical and pathologic entity separate from mononeuritis multiplex. These patients have a generalized neuropathy, and it is postulated that disordered neuron-axonal metabolism forms the basis for the pathologic and clinical changes. Histochemical changes in the muscle biopsy showed type I predominance. We suggest that this phenomenon represents a conversion of surviving fibers, of whatever type, to a type I oxidative metabolism because of the change in use of these fibers.

Dr. Williams' present address is Institute of Neurology, The National Hospital, Queen Square, London WC1N 3BG, England.

Supported in part by grants PHS RR 5379 and PHS NS 06779 from the National Institutes of Health, U.S.P.H.S.

Presented at the American Academy of Neurology, Boston, Massachusetts, April, 1973.

Received for publication June 20, 1975.




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