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Diabetic Mononeuropathy

Diabetic Mononeuropathy Simplex


Presentation

  • present the importance regarding the impacts of diabetic neuropathic deficits on patients' functional capacity.[ncbi.nlm.nih.gov]
  • Cardiovascular autonomic neuropathy was present in two of the patients and there was improvement after treatment in the Ewing's tests -- Valsalva manoeuvre, deep-breathing test and lying-to-standing test.[ncbi.nlm.nih.gov]
  • The present study suggests that improvement of intraneural microcirculation by PGE1 administration results in an immediate recovery from diabetic oculomotor nerve palsy.[ncbi.nlm.nih.gov]
  • Peripheral sensory neuropathy Sensory neuropathy most commonly presents as symptomless symmetrical sensory loss in distal extremities i.e. feet and less commonly hands.[nhshighland.scot.nhs.uk]
  • Presentation The presentation depends on the type of neuropathy involved. 50% of people with diabetic polyneuropathy may have no symptoms and are only diagnosed by careful, regular and thorough clinical examination [ 3 ].[patient.info]
Epilepsy
  • Most agents that are used to treat painful diabetic neuropathy are often used to treat other conditions such as epilepsy, depression, and other types of pain.[healthcentral.com]
  • Drug treatment for neuropathic pain Medications that may help include: drugs normally used for epilepsy, such as carbamazepine antidepressants, such as venlafaxine opioid painkillers, for example, oxycodone or tramadol Opioid painkillers come with warnings[medicalnewstoday.com]
  • Other medications may include anti-epilepsy medications. Over-the-counter pain medications may also be useful for managing diabetic neuropathy symptoms that affect your sleep.[soundsleephealth.com]
  • Some use the epilepsy drug gabapentin (Neurontin, a predecessor to pregabalin that now has a generic equivalent), while others relieve symptoms with local anesthetics or muscle relaxants.[nfb.org]
  • Medications that are used to manage pain of diabetic neuropathy are used in other conditions as well such as epilepsy and depression.[gluxus.com]
Malnutrition
  • […] erectile dysfunction due to DM 2, neurogenic erectile dysfunction due to type 2 diabetes mellitus, neurologic disorder associated with diabetes mellitus, neurologic disorder associated with type II diabetes mellitus, neurological disorder associated with malnutrition-related[healthresearchfunding.org]
  • […] erectile dysfunction due to DM 2 Neurogenic erectile dysfunction due to type 2 diabetes mellitus Neurologic disorder associated with diabetes mellitus Neurologic disorder associated with type II diabetes mellitus Neurological disorder associated with malnutrition-related[icd9data.com]
  • Diabetic peripheral neuropathy Lumbosacral plexopathy co-occurrent and due to diabetes mellitus Neurologic disorder associated with diabetes mellitus Neurologic disorder associated with type 2 diabetes mellitus Neurological disorder associated with malnutrition-related[icdlist.com]
Limb Pain
  • The distal lower limb pain is severe, with burning and tightness of the feet. Depression is not uncommon.[jnnp.bmj.com]
Yawning
  • By Richard Klasco, M.D Photo Credit Ask Well Photo Credit Why Do We Yawn? Reading about yawning makes people yawn. You are probably yawning right now. By Roni Caryn Rabin Latest Search Latest Articles Search Articles 13845 results for sorted by[nytimes.com]
Delayed Gastric Emptying
  • Gastroparesis Assessment Delayed gastric emptying may cause recurrent hypoglycaemia which is often post prandial. People with diabetes may present with early satiety; feeling of fullness; abdominal bloating or upper abdominal pain and discomfort.[nhshighland.scot.nhs.uk]
  • Any of the nerves that are part of the autonomic nervous system can be damaged in autonomic neuropathy leading to problems including: urinary retention or incontinence, erectile dysfunction, constipation or diarrhea, difficulty swallowing or delayed gastric[universityhealthnews.com]
  • Motility studies, such as scintigraphy after a radiolabeled meal, are helpful in the evaluation of nausea, vomiting, early satiety, and delayed gastric emptying.[aafp.org]
Hypotension
  • […] for the Treatment 321 Pathophysiology of Neuropathic Pain 339 Treatment of Painful Diabetic Neuropathy 351 Focal and Multifocal Diabetic Neuropathy 367 Hypoglycemia and the Autonomic Nervous System 379 Cardiovascular Autonomic Neuropathy 389 Postural Hypotension[books.google.com]
  • When managing the symptoms of autonomic neuropathy, include standard interventions for the manifestations encountered (eg, abnormal sweating and postural hypotension).[patient.info]
  • Postural Hypotension Assessment Measure systolic BP before and 2 minutes after adopting a standing position from a lying down position. A fall of 30mmHg is abnormal.[nhshighland.scot.nhs.uk]
  • The PDE5 inhibitors potentiate the hypotensive effects of nitrates and their use is contraindicated in patients who are concurrently using organic nitrates in any form.[health.am]
  • Incontinence of urine Inability to empty the bladder completely Decrease in vaginal lubrication in women Profuse sweating, for example when eating or at night Bloating Difficulty swallowing Low blood pressure upon standing up suddenly ( orthostatic hypotension[medicinenet.com]
Orthostatic Hypotension
  • hypotension ) Rapid resting heartbeat Signs and symptoms of diabetic focal neuropathy also depend upon the location of the affected nerve.[medicinenet.com]
  • This can cause a sharp drop in pressure when you stand after sitting (orthostatic hypotension), which may lead to dizziness and fainting. Digestive problems .[fortishealthcare.com]
  • Clonidine has been reported to lessen diabetic diarrhea; however, its usefulness is limited by its tendency to lower blood pressure in these patients who already have autonomic neuropathy, resulting in orthostatic hypotension.[health.am]
  • Take care when prescribing antihypertensive medicines or tricyclic antidepressants not to expose people to the risks of orthostatic hypotension as a result of the combined effects of sympathetic autonomic neuropathy and blood pressure-lowering medicines[patient.info]
Ulcer
  • Association grant to develop a scale to assess patients’ cognitive and emotional representations of neuropathy and is currently funded by the National Institutes of Health (NIH) to study the effects of stress on wound healing in diabetic neuropathic foot ulceration[books.google.com]
  • Neuropathy may be the first sign of type 2 diabetes.The loss of protective sensation as a consequence of peripheral neuropathy is the most important risk factor of diabetic foot ulcer.[books.google.com]
  • , DM 2 w diabetic neuropathic foot ulcer, DM 2 w diabetic neuropathic heel and midfoot ulcer, DM 2 w diabetic neuropathic toe ulcer, DM 2 w diabetic neuropathy, DM 2 W diabetic peripheral neuropathy, DM 2 w diabetic peripheral sensory neuropathy, DM 2[healthresearchfunding.org]
  • DM 2 w diabetic neuropathic foot ulcer DM 2 w diabetic neuropathic heel and midfoot ulcer DM 2 w diabetic neuropathic toe ulcer DM 2 w diabetic neuropathy DM 2 W diabetic peripheral neuropathy DM 2 w diabetic peripheral sensory neuropathy DM 2 W diabetic[icd9data.com]
  • Usual locations of ulcers in the diabetic foot. Ulceration is particularly likely to occur over the dorsal portion of the toes and on the plantar aspect of the metatarsal heads and the heel.[quizlet.com]
Foot Ulcer
  • Neuropathy may be the first sign of type 2 diabetes.The loss of protective sensation as a consequence of peripheral neuropathy is the most important risk factor of diabetic foot ulcer.[books.google.com]
  • Usual locations of ulcers in the diabetic foot. Ulceration is particularly likely to occur over the dorsal portion of the toes and on the plantar aspect of the metatarsal heads and the heel.[quizlet.com]
  • Diabetic foot ulcers: a framework for prevention and care. Wound Repair Regen 1999;7:7–16. PMID: 10231501. Bloom S, Till S, Sonksen P, Smith S.[diabetesincontrol.com]
  • ulcer, DM 2 w diabetic neuropathic heel and midfoot ulcer, DM 2 w diabetic neuropathic toe ulcer, DM 2 w diabetic neuropathy, DM 2 W diabetic peripheral neuropathy, DM 2 w diabetic peripheral sensory neuropathy, DM 2 W diabetic polyneuropathy, DM 2 with[healthresearchfunding.org]
Anhidrosis
  • 321 Pathophysiology of Neuropathic Pain 339 Treatment of Painful Diabetic Neuropathy 351 Focal and Multifocal Diabetic Neuropathy 367 Hypoglycemia and the Autonomic Nervous System 379 Cardiovascular Autonomic Neuropathy 389 Postural Hypotension and Anhidrosis[books.google.com]
  • Hypotension (symptomatic in up to 12%) Resting tachycardia or loss of sinus arrythmia (up to 20%) Dysphagia with delayed gastric emptying, nausea/vomiting Constipation/diarrhoea Urinary retention/overflow incontinence Neuropathic oedema Gustatory sweating Anhidrosis[nhshighland.scot.nhs.uk]
  • Gustatory sweating, anhidrosis. Tends to be associated with peripheral neuropathy. People with both types 1 and 2 are affected. High mortality rate (50% within three years) mainly due to chronic kidney disease but there is often no obvious cause.[patient.info]
  • A reduced or complete lack of perspiration (anhidrosis) can be life-threatening. Autonomic neuropathy also causes excessive sweating, particularly at night. Social isolation.[fortishealthcare.com]
  • […] and fainting sexual dysfunction, erectile dysfunction in men, and problems with vaginal lubrication and arousal in women changes in perspiration, heavy night sweating, the inability to regulate internal temperature or complete lack of perspiration ( anhidrosis[draxe.com]
Foot Pain
  • On the 10th day, we found a decrease of 33% in foot pain and by the end of the second month, it fell by 65.5% (p 0.0001).[ncbi.nlm.nih.gov]
  • Symptoms can include: Vision trouble Shin or foot pain Severe lower back or pelvis pain Pain in the chest, side or belly[mainehealth.org]
  • Symptoms are specific to the affected nerve, and may include: Paralysis on one side of the face (Bell’s Palsy) Difficulty focusing, double vision or pain behind one eye Pain in the shin or foot Pain in the lower back or pelvis Pain in the front of the[informationaboutdiabetes.com]
  • Leg, shin, or foot pain. Lower back, pelvic, or abdominal pain. To manage symptoms, seek medical treatment if you experience symptoms of mononeuropathy, and tell your physician about all the symptoms you’re experiencing.[wwmedgroup.com]
  • Burning foot pain, often worse at night. Associated with poor glycaemic control but sometimes initially follows establishing good glycaemic control. Examination may be normal apart from hyperaesthesia.[patient.info]
Myopathy
  • Tendon reflexes: Reduced at ankles (50%) Treatment: Improvement in 1 patient with reduction of triglycerides Other disorders Tangier disease Triglyceride storage disease with impaired long-chain fatty acid oxidation Neutral lipid storage disease with myopathy[neuromuscular.wustl.edu]
Diplopia
  • Diplopia, blepharoptosis and decreased range of ocular movement, which were observed on admission, immediately began to improve at 1-4 days after the beginning of the treatment.[ncbi.nlm.nih.gov]
  • How mononeuropathy causes diplopia Among the nerves that might be affected by a mononeuropathy are the cranial nerves (nerves supplying the head).[diabetesmonitor.com]
  • Distribution: Common areas effected Wrist Drop ( Radial Nerve ) Loss of finger flexion and grip ( Median Nerve ) Foot drop (deep peroneal nerve, L4-L5) Recurrent laryngeal nerve Cranial Nerve palsy ( CN 3, CN 4, CN 6 ) Ophthalmoplegia, Ptosis, Diplopia[fpnotebook.com]
  • […] control Single nerve damage due to compression or ischemia Occurs in wrist (carpal tunnel syndrome), elbow, or foot (unilateral foot drop) Symptoms/Signs numbness edema pain prickling Mononeuropathies CN III, IV, and VI (and other CN's affected) causing diplopia[quizlet.com]
  • The patient with cranial nerve involvement usually has diplopia and single third, fourth, or sixth nerve weakness on examination but the pupil is spared. A full recovery of function occurs in 6-12 weeks.[health.am]
Ptosis
  • On the 10th day, we found significant improvement in the clinical signs of diabetic mononeuropathy - double vision, motility and position of the eyeball, ptosis of the upper eyelid and mydriasis.[ncbi.nlm.nih.gov]
  • Distribution: Common areas effected Wrist Drop ( Radial Nerve ) Loss of finger flexion and grip ( Median Nerve ) Foot drop (deep peroneal nerve, L4-L5) Recurrent laryngeal nerve Cranial Nerve palsy ( CN 3, CN 4, CN 6 ) Ophthalmoplegia, Ptosis, Diplopia[fpnotebook.com]
  • In addition to the double vision, damage to the third nerve may result in ptosis (dropping eyelid) and a dilated pupil.[diabetesmonitor.com]
  • No specific treatment is required other than prismatic help with diplopia as the ptosis recovers. Complete resolution normally occurs over 3–6 months.[jnnp.bmj.com]
  • Diabetic third nerve palsy presents with abrupt onset retro-orbital pain, followed by double vision, unilateral ptosis, restriction of medial and upgaze and sparing of the pupil.[jpma.org.pk]
Blepharoptosis
  • Diplopia, blepharoptosis and decreased range of ocular movement, which were observed on admission, immediately began to improve at 1-4 days after the beginning of the treatment.[ncbi.nlm.nih.gov]
Mononeuropathy
  • On the 10th day, we found significant improvement in the clinical signs of diabetic mononeuropathy - double vision, motility and position of the eyeball, ptosis of the upper eyelid and mydriasis.[ncbi.nlm.nih.gov]
  • CONCLUSIONS: The present study shows the patients with polyneuropathy suffer from more negative impacts on hand functional performance and quality of life than those with mononeuropathy and without neuropathy.[ncbi.nlm.nih.gov]
  • The effects of intravenously administered prostaglandin E1 (PGE1) on diabetic mononeuropathy was investigated in three patients with diabetic oculomotor palsy.[ncbi.nlm.nih.gov]
  • Median and ulnar mononeuropathy were gradual in onset and affected the dominant limb whereas other types of mononeuropathies were acute In onset with no predilection for either side.[diabetes.diabetesjournals.org]
  • It is suggested that all the asymmetric types of diabetic neuropathy, including the cranial-nerve palsies, mononeuropathies and mononeuropathy multiplex, are caused by infarcts within nerve.[nejm.org]
Polyneuropathy
  • CONCLUSIONS: The present study shows the patients with polyneuropathy suffer from more negative impacts on hand functional performance and quality of life than those with mononeuropathy and without neuropathy.[ncbi.nlm.nih.gov]
  • Cardiovascular Autonomic Neuropathy 389 Postural Hypotension and Anhidrosis 413 Structure and Function in Diabetes 165 Diabetic Encephalopathy 187 Microangiopathy Diabetes 207 Pathogenesis of Human Diabetic Neuropathy 231 Clinical Features of Diabetic Polyneuropathy[books.google.com]
  • (disorder of multiple nerves) diabetic, polyneuropathy (multiple nerve disorder), diabetic, polyneuropathy associated with type I diabetes mellitus, polyneuropathy associated with type II diabetes mellitus, polyneuropathy diabetic, symmetric diabetic[healthresearchfunding.org]
  • […] diabetic peripheral polyneuropathy.[medlink.com]
  • (disorder of multiple nerves) diabetic Polyneuropathy (multiple nerve disorder), diabetic Polyneuropathy associated with type I diabetes mellitus polyneuropathy associated with type II diabetes mellitus Polyneuropathy, diabetic Symmetric diabetic proximal[icd9data.com]
Cranial Neuropathy
  • The median, ulnar, and lateral popliteal nerves were most commonly affected and cranial neuropathy was relatively uncommon. When bilateral involvement of the same nerve was excluded, multiple mononeuropathies were found in only five patients.[diabetes.diabetesjournals.org]
  • Cranial neuropathy: Cranial neuropathy occurs when any of the twelve cranial nerves (nerves that exit from the brain directly) are damaged. Two specific types of cranial neuropathy are optic neuropathy and auditory neuropathy .[emedicinehealth.com]
  • neuropathies • Truncal neuropathy • Proximal diabetic neuropathy (diabetic amyotrophy, diabetic radiculoplexopathy) • Focal limb mononeuropathies The content you are trying to view is available only to logged in, current MedLink Neurology subscribers[medlink.com]
  • Focal syndromes such as carpal tunnel syndrome [9] (14-30%), radiculopathies/plexopathies, and cranial neuropathies account for the rest [10]. Motor Symptoms Motor problems may include distal, proximal, or more focal weakness.[physio-pedia.com]
  • Cranial neuropathy: The oculomotor nerves are most often affected (third, sixth, rarely fourth).[jpma.org.pk]
Foot Drop
  • Distribution: Common areas effected Wrist Drop ( Radial Nerve ) Loss of finger flexion and grip ( Median Nerve ) Foot drop (deep peroneal nerve, L4-L5) Recurrent laryngeal nerve Cranial Nerve palsy ( CN 3, CN 4, CN 6 ) Ophthalmoplegia, Ptosis, Diplopia[fpnotebook.com]
  • drop) Symptoms/Signs numbness edema pain prickling Mononeuropathies CN III, IV, and VI (and other CN's affected) causing diplopia and abnormality of visual fields *unilateral pain near the affected eye paralysis of the eye muscle double vision Foot care[quizlet.com]
  • Some of the most common are: axillary nerve dysfunction carpal tunnel syndrome common peroneal nerve dysfunction cranial mononeuropathy femoral neuropathy radial nerve dysfunction ulnar nerve dysfunction unilateral foot drop sciatic nerve dysfunction[healthline.com]
  • Sahani B, Spalding JMK: Diabetes mellitus presenting with bilateral foot drop. Lancet 1969;2:930–931. CrossRef Google Scholar (33).[link.springer.com]
  • Lower limb Foot drop, caused by a common peroneal nerve mononeuropathy, is uncommon.[diabetesincontrol.com]
Paresis
  • Four of them were with mononeuropathia multiplex and total ophthalmoplegia, affecting the oculomotor, trochlear and abducent nerves; 12 with paresis of the oculomotor nerve, one -- of the trochlear nerve and six -- of the abducent nerve.[ncbi.nlm.nih.gov]
  • The evolution of symptoms can be quite variable, and may progress to generalised lower limb paresis (“diabetic paraplegia”). A clinically indistinguishable syndrome occurs in patients without diabetes.[jnnp.bmj.com]
  • GASTROINTESTINAL AUTONOMIC NEUROPATHY Gastrointestinal autonomic neuropathy may cause paresis anywhere in the digestive tract, with damage to small myelinated and unmyelinated splanchnic nerves.[aafp.org]

Treatment

  • On the 10th day, we established a decrease in total symptom score by an average of 2.7 /- 1.4 points and by the end of the treatment period it was improved by 5.9 /- 1.9 points (p 0.04).[ncbi.nlm.nih.gov]
  • On the final day of the treatment, none of the above signs remained in the three cases.[ncbi.nlm.nih.gov]
  • المحتويات Aldose Reductase Inhibitors for the Treatment 309 Other Therapeutic Agents for the Treatment 321 Pathophysiology of Neuropathic Pain 339 Treatment of Painful Diabetic Neuropathy 351 Focal and Multifocal Diabetic Neuropathy 367 Hypoglycemia and[books.google.com]
  • Over recent years, there have been newadvances in our understanding and treatment of diabetic neuropathies and the problems associated with the disease.[books.google.com]
  • By GRETCHEN REYNOLDS Photo Credit Getty Images You asked How to Stop a Hot Flash Effective treatments are available to stop the discomfort of menopause symptoms.[nytimes.com]

Prognosis

  • Prognosis for Diabetics with Neuropathy The prognosis for diabetic neuropathy depends largely on how well the underlying condition of diabetes is handled.[agingcare.com]
  • What Is the Prognosis for Neuropathy? The outlook for nerve damage depends upon its cause.[emedicinehealth.com]
  • Prognosis [ 7, 9 ] Autonomic neuropathy is associated with a high mortality rate, mainly due to its association with chronic kidney disease, cardiopathy and hypotension.[patient.info]
  • IVIg: Hastens recovery; dose 2g/kg q month x3 Prognosis Slow recovery over 6 to 24 months after diabetic control Partial or complete Variant syndrome: Diabetic amyotrophy Nosology: Proximal diabetic neuropathy Frequency: Rare Onset: Sub-acute Associations[neuromuscular.wustl.edu]
  • The prognosis is generally good, and patients typically recover their baseline weight with resolution of the painful sensory symptoms within 1 year. 2.[health.am]

Etiology

  • Abstract Fifty-one diabetic patients with mononeuropathy were studied to examine possible etiological factors, to determine the relationship with other diabetic complications, and to correlate with the presence and severity of background peripheral and[diabetes.diabetesjournals.org]
  • Additionally, patients can be referred if the diagnosis is unclear or if a different etiology is suspected.[pharmacytimes.com]
  • You can also refer if the diagnosis is unclear or different etiology is suspected. DSPN pain management Pop-Busui mentions pain is often the reason many diabetic neuropathy patients seek help from their providers.[sciencedaily.com]
  • Disease Etiology With over 100 known types of peripheral neuropathy, the pathophysiology of this disease is not quite clear.[endocrinologyadvisor.com]
  • You can also refer if the diagnosis is unclear or different etiology is suspected.[labblog.uofmhealth.org]

Epidemiology

  • Epidemiological correlates of diabetic neuropathy. Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes 1989;38:1456–1461. PubMed CrossRef Google Scholar 7. Maser RE, Nielsen VK, Bass EB, et al.[link.springer.com]
  • Epidemiology and classification of diabetic neuropathy. Shefner JM, Dashe JF, eds. UptoDate. Wolters Kluwer Health. Accessed at: www.uptodate.com. 2013. 2. Rutkove SB. Overview of upper extremity peripheral nerve syndromes.[type2diabetes.com]
  • […] types IV & V collagen: Especially in innermost lamellae Endoneurial microvessles Increased types IV, V and VI collagen around microvessels CNS: Spinal cord atrophy reported with diabetes DIABETIC NEUROPATHIES: SYMMETRIC Chronic Distal: Sensory Autonomic Epidemiology[neuromuscular.wustl.edu]
  • Report from Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes. 1989, 38: 1456-1461.[bmcneurol.biomedcentral.com]
  • Determination of peripheral neuropathy prevalence and associated factors in Chinese subjects with diabetes and pre-diabetes - ShangHai Diabetic Neuropathy Epidemiology and Molecular Genetics Study (SH-DREAMS).[scielo.br]
Sex distribution
Age distribution

Pathophysiology

  • المحتويات Aldose Reductase Inhibitors for the Treatment 309 Other Therapeutic Agents for the Treatment 321 Pathophysiology of Neuropathic Pain 339 Treatment of Painful Diabetic Neuropathy 351 Focal and Multifocal Diabetic Neuropathy 367 Hypoglycemia and[books.google.com]
  • Disease Etiology With over 100 known types of peripheral neuropathy, the pathophysiology of this disease is not quite clear.[endocrinologyadvisor.com]
  • THE PATHOPHYSIOLOGY To better understand the pathophysiology of the disease, the Mayo researchers performed ipsilateral nerve biopsies on the 33 patients in their prospective study.[journals.lww.com]
  • Classification, clinical features and pathophysiological basis. Neurologist. 2005;11(2):63-79. [ Links ] 31 Lu B, Hu J, Wen J, Zhang Z, Zhou L, Li T, Hu R.[scielo.br]
  • This should include symptoms and signs, quantitative sensory testing, and electrophysiology [4] Classification A classification system by Thomas [11] combines anatomy and pathophysiology.[physio-pedia.com]

Prevention

  • These findings might assist both patients and clinicians in better realizing the impacts of neuropathic hands, and planning suitable strategies of intervention or health education to prevent declines in hand functions. 2017 The Authors.[ncbi.nlm.nih.gov]
  • The statement contains recommendations for physicians on the overall prevention of diabetic neuropathy, highlighting prevention as a key component because of the lack of treatment to reverse this condition.[empr.com]
  • In type 2 diabetes, work to effectively control glucose to prevent or slow the progression of DSPN. With type 2 diabetes, consider a multifactorial approach with targeting glycemia and other risk factors to prevent CAN.[sciencedaily.com]
  • Recommendations for overall diabetic neuropathy prevention are as follows: For patients with type 1 diabetes, try to control glucose as soon as possible to prevent or delay the development of DSPN and CAN.[pharmacytimes.com]

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