Topic 40 of 75 in the MU Plovdiv syllabus for Neurology (Medicine, Year 4). The free AceMed note covers it in 4 sections, about 853 words (6 min of reading), with 30 flashcards.
Neurological complications of acute and chronic alcoholism
Diabetic neuropathy
Peripheral nerve involvement in diabetes is common and may be characterized by polyneuropathy, which is of mixed (sensory, motor, autonomic) character in about 70% of cases and predominantly sensory in about 30%; mononeuropathy multiplex or mononeuropathy simplex.
Symptoms
Distal sensory or mixed polyneuropathy. Symptoms are more common in the legs: numbness, pain, and paresthesia. In severe cases there is distal sensory loss in all limbs and some accompanying motor disturbances
Diabetic dysautonomia leads to many symptoms, including postural hypotension, disturbances of cardiac rhythm, impaired thermoregulatory sweating, and disturbances of bladder, bowel, gastric, and sexual function.
Diabetic mononeuropathy multiplex is usually characterized by pain and weakness and often has a vascular basis. The clinical deficit depends on the nerves that are affected.
Diabetic amyotrophy is due to radiculoplexopathy, polyradiculopathy, or polyradiculoneuropathy. Pain, weakness, and atrophy of pelvic girdle and thigh muscles are typical, with absent quadriceps reflexes and little sensory loss.
Diabetic mononeuropathy simplex is typically sudden in onset and often painful.
CSF protein is typically increased in diabetic polyneuropathy and mononeuropathy multiplex.
Treatment
Vitamins group B
Thioctacid i.v. (thiogamma)
Neurontin
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