Neuro

Mononeuropathy in Diabetes

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Mononeuropathy in Diabetes, Diabetic Mononeuropathy, Diabetic Focal Neuropathy

  • Background
  1. Subtype of Diabetic Neuropathy
  2. Sudden onset large nerve involvement
  3. Associated with nerve infarction
  • Distribution
  • Common areas effected
  1. Wrist Drop (Radial Nerve)
  2. Loss of finger flexion and grip (Median Nerve)
  3. Foot Drop (deep peroneal nerve, L4-L5)
  4. Recurrent laryngeal nerve
  5. Cranial Nerve palsy (CN 3, CN 4, CN 6)
    1. Ophthalmoplegia, Ptosis, Diplopia yet PERRLA (CN 3)
    2. Affected eye slightly more elevated (CN 4)
    3. Affected eye deviated medially (CN 6)
    4. Bell's Palsy (CN 7)
  • Course
  1. Often resolves spontaneously in 3-12 months
  1. Multiple nerves affected
  2. Consider Vasculitis as cause
  • Differential Diagnosis
  1. See Mononeuropathy
  • Management
  1. See Diabetic Peripheral Neuropathy