Managing inflammatory diabetic neuropathies

摘要

Most diabetic neuropathies are felt to be related to metabolic and microvascularcomplicationsfrom prolonged periods of hyperglycemia, the classical example being diabetic polyneuropathy. Diabetic polyneuropathy is a symmetric slowly progressive distal predominant, sensory greater than motor neuropathy, commonly seen in neurological practice. However, there are subtypes of diabetic neuropathy, inflammatory in origin, which are important to identify, as the fundamental approach to treatment is different. The main categories of inflammatory diabetic neuropathy, which we will discuss in detail, including clinical presentation, evidence for an inflammatory pathophysiology, and the treatment strategies, are the different forms of radiculoplexus neuropathies (diabetic lumbosacral radiculoplexus neuropathy, diabetic cervical radiculoplexus neuropathy, diabetic thoracic radiculoneuropathy and painless motor and lower limb predominant neuropathy) and diabetic chronic inflammatory demyelinating polyradiculoneuropathy.