Clinical and Electrophysiological Abnormalities amongst the Patients of Diabetic Truncal Polyneuropathy
Journal Title: GCSMC Journal of Medical Sciences - Year 2017, Vol 6, Issue 2
Abstract
Introduction: Diabetic truncal polyneuropathy (DTPN) is a well-recognized form of diabetic neuropathy. Electrophysiological abnormalities have not been described in details in literature. Objective: To analyze clinical and electrophysiological abnormalities in patients with DTPN. Methods: A retrospective analysis of clinical and Electrodiagnostic studies (EDX) was carried out among nine patients with DTPN who attended our institute in last 12 years over the period of Jan 2003 to Aug 2015. Results: All nine patients (6 males, 3 females; aged 48-71 years) had type 2 diabetes mellitus (DM). Three patients were on Insulin and remaining patients were on oral hypoglycemic agents. Eight patients had DM for 2-10 years and one patient was diagnosed at presentation. All patients reported truncal paresthesia in a unilateral thoracic dermatomal distribution. Six patients had abdominal muscle weakness and one had proximal limb muscle weakness. EDXs revealed sensory motor polyneuropathy in all patients. Seven patients revealed abnormality on needle Electromyography (EMG) in limb muscles. Six patients revealed acute/chronic neuropathic changes on needle EMG in paraspinal muscles. Five patients revealed active denervation in abdominal muscles. Conclusion: DTPN presents with abdomino-thoracic painful paresthesia over usually two-three thoracic dermatomes with abdominal muscle weakness in two-thirds of patients. All patients had distal sensory motor peripheral neuropathy. Detailed clinical history and examination along with EMG/NCS studies can help in early diagnosis & management.
Authors and Affiliations
Chilvana Patel, Surya Murthy Vishnubhakat
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