Proximal diabetic neuropathy

Proximal diabetic neuropathy, also known as lumbosacral radioplexus neurophagy, femoral neurophagy and diabetic amyotrophy, is a nerve disorder that results as a complication of diabetes mellitus. It affects the thighs, hips, buttocks and legs. Proximal diabetic neurophagy is a peripheral nerve disease (diabetic neuropathy) characterized by painful muscle wasting and weakness. Diabetic neuropathy is a common complication of diabetes. It is defined as damage to the nerves that allow you to feel the sensation pain. There are a number of ways that diabetes damages the nerves, all of which seem to be related to increased blood sugar levels over a long period of time. Proximal diabetic neuropathy is one of four types of diabetic neuropathy.

Proximal diabetic neuropathy can occur in type 2 and type 1 diabetes mellitus patients however, it is most commonly found in type 2 diabetes patients. Proximal neuropathy is the second most common type of diabetic neuropathy and can be resolved with time and treatment.

Signs & Symptoms
Symptoms of proximal diabetic neuropathy depend on which nerves are affected. The first symptom is usually pain in the buttocks, hips, thighs or legs. This pain most commonly affects one side of the body and can either start gradually, seemingly minor at first, or can come on all of a sudden. This is followed by intense weakness in the proximal muscles of the lower limbs that can result in patients being unable to go from a sitting to standing position without assistance. This weakness begins unilaterally but can also spread bilaterally.

Proximal diabetic neuropathy is often accompanied by polyneuropathy, a malfunction of many peripheral nerves at the same time, and musclefasciculation, small, involuntary muscle twitches or contractions that are visible under the skin.

Causes
Diabetic neuropathy is caused by damage to nerves that allows one to feel sensations of pain. This damage appears to be linked to the nerves being exposed to high blood sugar levels for long periods of time. In the case of proximal diabetic neuropathy the nerves affected are located in the buttocks, thighs, hips and legs. Scientists do not know exactly how or why blood glucose affects the nerves, just that there appears to be a connection between the two.

Diagnosis
Motor and sensory nerve conduction studies and electromyographic examination of muscles are the basic techniques used for diagnosing the different types of diabetic neuropathies. Both nerve conduction studies and electromyography study the large diameter myelinated fibers. This can sometimes lead to misleading results for patients with small diameter fiber neurophagy.



Treatment
Proper management of diabetes mellitus can prevent proximal diabetic neuropathy from ever occurring.

Proximal diabetic neuropathy is very much reversible. This can be done by taking various measures such as:
 * Controlling the blood sugar levels
 * Proper eating habits, medication, physical exercise, good mental health and avoiding harmful habits like drinking, smoking etc. all form a part of the lifestyle to control diabetes.
 * Physical therapy to restore the nerves in the legs is very useful, it brings back feeling in the legs.
 * Medication helps reduce the pain involved in proximal diabetic neuropathy. Most patients take oral medication that is prescribed by a doctor. Common types include antidepressants, opiates or opiate like drugs, and anticonvulsants.

Length of treatment varies with the amount of nerve damage.