PROXIMAL DIABETIC NEUROPATHY - CLINICAL SIGNS AND NEUROPHYSIOLOGICAL PARAMETERS

The aim of the study was to define the characteristic neurophysiological parameters and clinical signs of proximal diabetic neuropathy (PDN). Twelve patients with PDN (Group 1) and 30 patients with distal symmetric diabetic polyneuropathy (DSDP) but without signs and symptoms of PDN (Group 2) were examined. The groups were comparable with regard to age, gender and diabetes duration. In Group 1 all patients had type 2 diabetes, mean PDN symptoms duration 4.3 + 1.8 months, whereas duration of distal polyneuropathy symptoms in the same patients was 3.2 + 2.3 yrs. Clinical picture in all Group 1 patients was characterised by pronounced pain in the upper legs (mean visual analogue scale value = 7.4 cm), atrophy of upper leg muscles, loss of predominantly pelvifemoral muscle strength and significant weight loss. Bilaterally affected upper legs were recorded in 9 patients and unilateral in 3. Among neurophysiological parameters significant difference between Group 1 and Group 2 was found in motor conduction velocity of femoral nerve (37.3 vs. 61.4 m/s, p<0.0001), while no significant difference was found for peroneal and sural nerves. PDN is present in type 2 diabetics and is characterised by pain, muscle atrophy in upper legs, weight loss and reduced motor conduction velocity of femoral nerve.