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Proximal diabetic neuropathy, also known as diabetic amyotrophy, is a complication of diabetes mellitus that affects the nerves that supply the thighs, hips, buttocks and/or lower legs. Proximal diabetic neuropathy is a type of diabetic neuropathy characterized by muscle wasting, weakness, pain, or changes in sensation/numbness of the leg.
Gowers's sign is a medical sign that indicates weakness of the proximal muscles, namely those of the lower limb. The sign describes a patient that has to use their hands and arms to "walk" up their own body from a squatting position due to lack of hip and thigh muscle strength. It is named after William Richard Gowers. [1] [2]
The predominant symptoms of NC involve one or both legs and usually presents as some combination of tingling, cramping discomfort, pain, numbness, or weakness in the lower back, calves, glutes, and thighs and is precipitated by walking and prolonged standing. However, the symptoms vary depending on the severity and cause of the condition.
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
Weakness comes on slowly (over months to years) in an asymmetric manner and progresses steadily, leading to severe weakness and wasting of arm and leg muscles. IBM is more common in men than women. [10] Patients may become unable to perform activities of daily living and most require assistive devices within 5 to 10 years of symptom onset.
Engage core, keep back straight, and gently lean trunk forward and tuck pelvis slightly forward until you feel a moderate stretch in front of thigh. Hold for 90 seconds to 2 minutes. Repeat on the ...
If the patient is asked to raise the other leg (i.e. flexion at the contra-lateral hip), the examiner will feel pressure on his or her hand as the patient involuntarily extends the weak hip. This can be pointed out to the patient in a non-confrontational manner, to help persuade the patient of the functional nature of the weakness. [3]
True muscle weakness is a primary symptom of a variety of skeletal muscle diseases, including muscular dystrophy and inflammatory myopathy. It occurs in neuromuscular junction disorders, such as myasthenia gravis. Muscle weakness can also be caused by low levels of potassium and other electrolytes within muscle cells. It can be temporary or ...