II. Background

  1. Subtype of Diabetic Neuropathy
  2. Sudden onset large nerve involvement
  3. Associated with nerve infarction

III. 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)

IV. Course

  1. Often resolves spontaneously in 3-12 months

V. Associated Conditions: Mononeuropathy Multiplex (variant)

  1. Multiple nerves affected
  2. Consider Vasculitis as cause

VI. Differential Diagnosis

VII. Management

  1. See Diabetic Peripheral Neuropathy

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