A Rare Cause of Proximal Thigh Discomfort and Weakness with Type 2 Diabetes Mellitus

Abstract

Diabetic amyotrophy also known as Bruns-Garland syndrome or Diabetic Lumbosacral Radiculoplexus neuropathy is diabetic neuropathy subtype affecting the lumbrosacral nerve roots and peripheral nerves1. There is an ongoing debate on the pathophysiology behind this condition whether is it ischemic, metabolic (hyperglycemia) or inflammatory1. We think that the likely cause responsible is due to an ischemic injury from a nonsystemic microvasculitis. There is a series of studies involving diabetic amyotrophy conducted with 33 patients, nerve biopsy specimens showed features of multifocal fiber loss, perineurial thickening, neovascularization and abortive regeneration of nerve fibers forming microfasciculi2. These findings are suggestive of an ischemic process due to microvascuitis2