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Besides distal symmetrical sensory polyneuropathy(DSSP),middle-aged diabetic patients may present with focal or multifocal neuropathies, including proximal neuropathy of the lower limbs,the pathyphysiological features of which are uncertain.We studied 10 non-insulin-dependent diabetic patients,45 to 72 years of age,who developed a painful proximal neuropathy of the lower limbs for which other causes of neuropathy were carefully excluded.This study shows that axonal and demyelinative lesions similar to those found in diabetic DSSP are present in proximal nerves in mild forms of proximal diabetic neuropathy;while nerve ischemia, inflammatory infiltration,and vasculitis are encountered in the most severe forms of proximal diabetic neuropathy. |
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