Diabetic amyotrophy is a complication of diabetes that affects either the femoral nerve or the three roots that contribute to the femoral nerve. It is also known as neuralgic amyotrophy or diabetic amyotrophy of Garland. It is more common in males, and generally occurs in type 2 diabetes. Clinical features severe pain down the anterior thigh, that often radiates down to the medial aspect of the leg and ankle. The patient will usually have had rapid weight loss and poor health in the weeks prior to symptoms. After a few days, the pain improves and the patient suddenly has rapid muscle wasting with weakness of quadriceps and is unable to walk. There is usually eventual improvement from 6 months, but it can take up to two years for full recovery.
In other cases there are lesions of L2, L3, and L4 nerve roots rather than the femoral nerve. In this situation there is a more widespread motor deficit and wasting, with involvement of the hip flexors and adductor muscles.
Good glucose control is imperative.
- Patten, John. Neurological differential diagnosis. London New York: Springer, 1996.