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Journal of the Korean Academy of Rehabilitation Medicine 1996;20(4):36.
Diabetic Amyotrophy
Myung Heun Lee, M.D., Yoon Kyoo Kang, M.D. , Sei Joo Kim, M.D.
Department of Rehabilitation Medicine, College of Medicine, Korea University
당뇨병성 근위축증의 증례 보고
이명흔, 강윤규, 김세주
고려대학교 의과대학 재활의학교실

Neuropathies in association with diabetes mellitus are symmetrical peripheral neuropathy, mononeuropathy, radiculopathy, autonomic visceral neuropathy, and diabetic cranial neuropathy. The common form of diabetic neuropathy is a distal polyneuropathy whereas diabetic amyotrophy is caused by proximal lesions.

Diabetic amyotrophy is a syndrome consisting of bilateral, but often asymmetrical, proximal muscle weakness and atrophy primarily affecting the lower extremities accompanied by pain in the back or the thighs. It is usually seen in patients with poorly controlled or previously unrecognized diabetes mellitus, and severe weight loss is a common concomitant.

A 56-year-old woman diagnosed as diabetes mellitus 4 years ago, was admitted with weight loss, severe pain and weakness in the right thigh causing difficulty in walking and climbing stairs. She is a slender woman with severe muscle atrophy of right thigh.

Magnetic resonance imaging of the lumbosacral spine showed bulge in the annulus fibrosus at left side L4-5, no compromise of the L2-3, L3-4 spinal canal. Electrodiagnosis revealed proximal motor neuropathy in the muscles innervated by L2, L3 and L4 roots and distal symmetric polyneuropathy. The extensive studies for evaluating the cancer were free of abnormality. After 6 months, symptoms were improved with diabetic control and she could walk a short distance. These findings were compatible with diabetic amyotrophy.

Key Words: Diabetic amyotrophy, Neuropathy, Proximal weakness, Diabetes mellitus
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