Diabetic Amyotrophic Neuralgia

Abstract

Amyotrophic neuralgia is an idiopathic and inflammatory neuropathy characterized by acute-subacute onset of pain and weakness. It can rarely occur in diabetic patients as a form of diabetic neuropathy. In this study, we aimed to present clinical, electromyographic and radiological features of a case with diabetic amyotrophic neuralgia. A 58-years-old female patient was admitted to our department with low back pain. Her medical history revealed that the pain had started one month ago and radiated from the low back to the bilateral hips and left lower extremity significantly. Visual Analogue Scale (VAS) score of low back pain was 100 mm. She also reported that she had the diagnosis of diabetes mellitus for score ten years. On physical examination; the movements of the lower back were decreased and painful. The muscle strength of lower extremities were 1+/5 proximally and 2+/5 distally. Electromyographic assessment was compatible with sensory-motor axonal polineuropathy on lower extremity and diabetic amyotrophic neuralgia. A medical treatment consisting of pregabalin as 150 mg daily was administered. Severity of low back pain decreased to 10 mm after the treatment. Clinicians should take into consideration this pathology in patients with diabetes mellitus, pain and weakness. Electromyography and Magnetic Resonance Imaging (MRI) findings can be useful in differential diagnosis.