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Diabetische Neuropathie

Nicht nur an die distal-symmetrische Neuropathie denken

Diabetic neuropathy

Do not only consider distal symmetrical neuropathy

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Zusammenfassung

Hintergrund

Die diabetische Neuropathie ist eine typische Komplikation des Diabetes mellitus. Während die häufigste distal-symmetrische Form meist sicher diagnostiziert werden kann, werfen die selteneren Formen der diabetischen Neuropathie differenzialdiagnostische Probleme auf, eröffnen aber oft eigenständige Behandlungsmöglichkeiten zusätzlich zur verbesserten Blutzuckerkontrolle.

Ziel der Arbeit

Diese Übersichtsarbeit soll einen Überblick über die selteneren Formen der diabetischen Neuropathie, ihren Stellenwert sowie diagnostische und therapeutische Möglichkeiten geben.

Ergebnisse

Vorgestellt werden die autonome diabetische Neuropathie, die Small-fiber-Neuropathie bei Diabetes mellitus und die seltenen Formen, wie diabetische Radikuloplexopathie, die diabetische Neuropathie der Hirnnerven, die therapieinduzierte Neuropathie und alternative Neuropathieursachen bei Diabetikern.

Diskussion

Die Diagnostik der selteneren Neuropathieformen und speziell ihre Abgrenzung gegenüber alternativen Neuropathieursachen bereitet in der Praxis häufig Schwierigkeiten. Diese Übersichtsarbeit soll den Umgang mit verschiedenen Formen der diabetischen Neuropathie erleichtern und Hilfestellung in der Erkennung alternativer Neuropathieursachen geben.

Summary

Background

Diabetic neuropathy is a common complication of diabetes mellitus. The length-dependent symmetrical sensorimotor type of neuropathy is the most prevalent form of diabetic neuropathy but other forms of diabetic neuropathy also need to be kept in mind. Their differential diagnosis is often more challenging but implicates specific forms of treatment other than improvement of metabolic control.

Aim of the study

This article gives an overview of the less frequent forms of diabetic neuropathy and discusses their impact, diagnostic and therapeutic implications.

Results

Autonomic diabetic neuropathy, diabetic small fiber neuropathy and less frequent forms of diabetic neuropathy, such as diabetic radiculoplexopathy, diabetic neuropathy of cranial nerves, therapy-induced neuropathy and alternative causes of peripheral neuropathy in patients with diabetes are described.

Discussion

Diagnosis of less frequent subtypes of diabetic neuropathy and differentiation towards alternative causes of peripheral neuropathy are often difficult in daily medical routine. Diagnostic clues are helpful in identifying rarer forms of diabetic neuropathy, thus enabling more specific treatment.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. K. Doppler: Vortragstätigkeiten für Baxter, Reisekostenerstattung durch Eli Lilly, Pfizer und Orion Pharma. K. Reiners erklärt, dass er Vortragshonorare erhalten hat von den Firmen Baxter Deutschland GmbH, MerckSerono GmbH, Pfizer GmbH und Wörwag Pharma GmbH. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Neurologische Klinik, Universitätsklinikum Würzburg, Josef-Schneider-Str. 11, 97080, Würzburg, Deutschland

    K. Doppler & K. Reiners

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  1. K. Doppler
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Correspondence to K. Doppler.

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Doppler, K., Reiners , K. Diabetische Neuropathie. Nervenarzt 86, 161–166 (2015). https://doi.org/10.1007/s00115-014-4127-2

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