An individual nerve may be affected, such as the peroneal, resulting in footdrop, the seventh cranial nerve causing Bell's palsy, or the extraocular nerves causing strabismus and dip-lopias. Similar to other causes of Bell's palsy, the pathogen-esis of these large-nerve injuries is thought to result from vascular injury; the paralysis is usually self-limiting and spontaneously improves over several months. In general, all these neuropathies have become less common as average HbA1c levels have fallen from above the 9% range over the last 10 years.

Occasionally, a diabetic mononeuritis with a localized region of pain can be misdiagnosed clinically as a mechanically mediated neuritis, such as a herniated intravertebral disk. If the appropriate imaging studies fail to demonstrate a mechanical etiology, a presumptive diagnosis of diabetes neuritis should be made and treatment aimed at glycemic control with physical therapy. On the other hand, diabetic neuritis of this type with constant pain may be initiated by mechanical factors. For example, a diabetic patient may acutely injure spinal nerves with a lifting maneuver, but this "neuromuscular pain" may become a continuing neuropathic pain as diabetic nerve fibers fail to heal in the presence of marked hyperglycemia. With no other etiologies evident, these patients eventually improve with more effective diabetic management.

Peripheral Neuropathy Natural Treatment Options

Peripheral Neuropathy Natural Treatment Options

This guide will help millions of people understand this condition so that they can take control of their lives and make informed decisions. The ebook covers information on a vast number of different types of neuropathy. In addition, it will be a useful resource for their families, caregivers, and health care providers.

Get My Free Ebook

Post a comment