Diabetic proximal neuropathy of the lower limbs (diabetic amyotrophy) occurs when a major nerve in one or both lower extremities (such as the femoral nerve) suffers damage.


Many patients are over 50 years of age.


Clinical features:

(1) weakness and wasting involving muscles the pelvic girdle and thigh (typically the quadriceps if the femoral nerve is involved, but also the iliopsoas and thigh adductors)

(1a) difficulty walking

(1b) difficulty climbing stairs

(2) aching, burning or stabbing pains

(3) numbness and sensory loss over the anterior thigh

(4) loss of tendon reflexes (patellar, others)

(5) It may be asymmetrical, involving one or both limbs. If one limb is involved, then a relapse may occur on the opposite side.


Some patients may develop an extensor plantar reflex (Babinski's sign).


The syndrome may improve after several months if the patient has good glycemic control, but relapses may occur.


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