Clinical manifestations of diabetic polyneuropathy
Sep 09, 2022
Source: Cainiu Health
Dr. Pan Yongyuan
Introduction
Clinical manifestations of diabetic polyneuropathy include distal symmetric polyneuropathy, focal mononeuropathy, multiple mononeuropathies (mononeuritis multiplex), and autonomic neuropathy. Distal symmetric polyneuropathy has a relatively insidious onset and progresses slowly, primarily affecting the extremities of the limbs. Focal neuropathies mainly involve the ulnar nerve, cranial nerves, and others.
Diabetic polyneuropathy clinically manifests as distal symmetric polyneuropathy, focal mononeuropathy, multiple mononeuropathies (mononeuritis multiplex), and autonomic neuropathy.
1. Distal Symmetric Polyneuropathy
Distal symmetric polyneuropathy develops insidiously and progresses slowly. It primarily affects the extremities, causing sensory abnormalities such as tingling, pain, and numbness that are distributed in a "stocking-and-glove" pattern. Symptoms typically begin in the lower limbs and occur symmetrically, often worsening at night.
2. Focal Mononeuropathy
Focal mononeuropathy mainly involves the ulnar nerve, median nerve, cranial nerves, and other peripheral nerves, with facial palsy being a common presentation.
3. Multiple Mononeuropathies (Mononeuritis Multiplex)
Multiple mononeuropathies have an acute onset and most commonly affect proximal muscle groups in the lower limbs. They present with unilateral pain, weakness, aching, or dull pain in proximal muscles, with symptoms worsening at night. Muscle atrophy typically develops within 2–3 weeks.
4. Autonomic Neuropathy
Autonomic neuropathy may lead to syncope, hypotension, and abnormal coronary artery vasoconstriction, among other dysfunctions.
