Polyneuropathy pt2 Diabetes

Question 1

Briefly define the term Diabetic Polyneuropathy.

Answer 1

One of the most common symptomatic complications of diabetes. Since T2 diabetes has no clinical features and is generally diagnosed by default with pathophysiological features that vary widely between populations, a more accurate clinical name for this would be idiopathic hyperglycaemia with associated polyneuropathy

Question 2

Describe the “typical” patient who is affected by: Diabetic polyneuropathy

Answer 2

Diabetic patient, especially those with a poor glycemic control, also duration of disease; the longer the patient has diabetes the greater the risk of developing Diabetic polyneuropathy. Also age, smoking, hypertension, height and hyperlipidaemia are all risk factors.

Question 3

Describe the “typical” patient who is affected by: Diabetic mononeuropathy

Answer 3

Middle aged patient with a long duration of mild Diabetes Mellitus
This may have been brought on by trauma or any other mechanism that causes entrapment, compression or focal ischeamia of a single peripheral nerve

Question 4

Describe the clinical manifestations of Diabetic neuropathy that affects:
Mixed diameter nerve fibres

Answer 4

Loss of proprioception
Loss of vibration sense
Loss of deep tendon reflexes
Abnormal nerve conduction

Question 5

Describe the clinical manifestations of Diabetic neuropathy that affects:
Small diameter nerve fibres

Answer 5

Burning or lancinating pain
Hyperalgesia
Paresthesia and dysesthesia
Decreased Pain & Temp perception
Visceral pain perception deficits
Foot ulceration

Question 6

What is Diabetic Mononeuropathy

Answer 6

Neuropathy of a single nerve that is associated with Diabetes Mellitus

Question 7

Discuss the typical clinical manifestations of diabetic mononeuropathy affecting the Oculomotor nerve.

Answer 7

Acute onset of ssx
Observe HA (retroorbital, forehead)
Paralysis of striated mm supplied by nerve
Ddx from compressive neuropathy is necessary – in DMN the pupillary function is usually spared
Spontaneous recovery in several weeks

Question 8

Discuss the prognosis of Diabetic Mononeuropathy.

Answer 8

Usually more or less complete recovery within several weeks