DIABETIC AMYOTROPHY - CURRENT CONCEPTS

Diabetic amyotrophy is a disabling illness that is distinct from other forms of diabetic neuropathy, It is characterized by weakness followe d by wasting of pelvifemoral muscles, either unilaterally or bilateral ly, with associated pain, Sensory impairment is minimal in the cutaneo us distribution sharing the same root or peripheral nerve as affected musculature. Most commonly, the onset is in middle age or later, altho ugh it may occur in youth, A concomitant distal predominantly sensory neuropathy may be present, Electrodiagnostic studies are most often co nsistent with a neurogenic lesion attributable to a lumbosacral radicu lopathy, plexopathy, or proximal crural neuropathy. The natural course of the illness is variable with gradual but often incomplete improvem ent, The site of the lesion and the pathogenesis of diabetic amyotroph y remain controversial, Recent studies suggest a role for immunomodula ting agents in certain types of diabetic neuropathy, including diabeti c amyotrophy.