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Proximal diabetic neuropathy presenting with respiratory weakness
  1. Thomas H Brannagana,
  2. Robert A Promisloffb,
  3. Leo F McCluskeyc,
  4. Kathleen A Mitza
  1. aMCP-Hahnemann University School of Medicine, Department of Neurology, bDepartment of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Pennsylvania, USA, cDepartment of Neurology, University of Pennsylvania Medical Center, Pennsylvania Hospital, Pennsylvania, USA
  1. Dr Thomas Brannagan, MCP, Hahnemann University School of Medicine, Department of Neurology, Broad and Vine, Mail Stop 308, Philadelphia, PA 19102, USA. Telephone 001 215 762 5036; fax 001 215 762 1537; emailBrannagan{at}


A patient is described with proximal diabetic neuropathy presenting with respiratory weakness. A 50 year old man developed progressive shortness of breath over 2 months. He also had weakness of hip flexion. Phrenic nerve responses were absent, and spontaneous activity was seen in the intercostal and lumbar paraspinal muscles with long duration neurogenic MUPs and reduced recruitment in the diaphragm. Without treatment, the patient began to improve with resolution of his proximal leg weakness and breathing difficulties. Proximal diabetic neuropathy is another cause of neuromuscular respiratory weakness.

  • proximal diabetic neuropathy
  • diabetic amyotrophy
  • respiratory weakness
  • phrenic nerve
  • diaphragm

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