How does diabetic amyotrophy present?
This will occur in those with type 2 diabetes. Common presentation is acute, asymmetric, and focal onset of pain and weakness usually in the proximal leg. This will progress over the course of a few months and then partially or fully resolve over time. As this pain progresses, symptoms may become symmetric. Weight loss may be associated with onset of diabetic amyotrophy. Electrodiagnostic testing, namely nerve conduction studies, show significant reduction in motor amplitudes and sensory action potentials but mild slowing of conduction velocities. EMG testing will show fibrillation potentials as well as decreased recruitment, with motor units demonstrating high amplitude and long duration. Lumbar imaging may be used to rule out other sources of nerve injury stemming from the spine. Symptomatic management with neuropathic pain agents and consideration of opioid pain management may be considered.