Radiculoplexus Neuropathy

Radiculoplexus Neuropathy; Diabetic/non-diabetic
Diabetic radiculoplexus neuropathy (DRPN)-

Seen in type II DM; does not appear related to prolonged excess glucose exposure.
Present with sudden or sub-acute onset of pain/weakness-asymmetrical pattern-proximal segments often involved.

Usually monophasic illness.
Associated with weight loss.
Three subtypes

Diabetic lumbosacral radiculoplexus neuropathy.
Diabetic cervical radiculoplexus neuropathy-often referred to as Parsonage -Turner syndrome/neuralgic amyotrophy.
Diabetic thoracic radiculoplexus neuropathy.
Pathophysiology does not appear related to prolonged excess glucose exposure.

Syndromes appear to be caused by microvasculitis and ischemic injury.
Immune attack-inflammatory cell reaction.
Evidence of multifocal fiber degeneration and loss; abortive repair with neuroma formation, thickened perineurium.

Segmental demyelination and axonal loss observed.
Demyelinating changes tended to be clustered on individual axons, which is typical of demyelination secondary to axonal dystrophy.
 Immunotherapy may be the best treatment.
Autonomic symptoms common.

Orthostatic intolerance, sexual dysfunction, urinary dysfunction, diarrhea, constipation, sweat pattern change.
Non-Diabetic RPN

Essentially same as diabetic version.

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Ray Jurewicz
E-mail: rj@NerveStudy.com Web Site design by Larry Berman and Chris Maher

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