What symptom does diabetic hand and foot numbness have?
summary
Among the peripheral neuropathy caused by diabetes mellitus, symmetrical somatosensory neuropathy is the most common, especially multiple peripheral sensory neuropathy at the distal extremity, followed by symmetrical motor neuropathy. The main neuropathological changes are segmental demyelination of nerve fibers and axonal degeneration, which lead to disturbance of nerve impulse conduction. What symptom does diabetic hand and foot numbness have? Let's talk about it.
What symptom does diabetic hand and foot numbness have?
Among the peripheral neuropathy caused by diabetes mellitus, symmetrical somatosensory neuropathy is the most common, especially multiple peripheral sensory neuropathy at the distal extremity, followed by symmetrical motor neuropathy. The main neuropathological changes are segmental demyelination of nerve fibers and axonal degeneration, which lead to disturbance of nerve impulse conduction. Lesions are often more extensive, generally first distal, then proximal, the disease gradually aggravated, sensory nerve damage is mostly symmetrical and multiple.
Distal peripheral symmetrical sensory neuropathy. This type is characterized by bilateral distal sensory disturbance, more common in lower limbs than in upper limbs, and no obvious motor disturbance. Patients often have numbness, ant walking and burning sensation in feet, ankles and lower parts of legs, as well as acupuncture like pain, sometimes painful spasm, and some patients even feel that their feet are stepping on cotton. During physical examination, typical cases may have sock like and glove like sensory disturbance; Some Achilles tendon reflex and knee reflex were weakened or disappeared; The sense of vibration and position of tuning fork decreased or disappeared; Electromyogram showed that nerve conduction velocity decreased. When the deep and superficial pain of the lower limb is lost, the joint lesions of the foot and ankle, as well as the ulcer of the lower limb may appear. Distal symmetric motor neuropathy may result in bilateral symmetrical myasthenia of the lower limbs, or accompanied by sensory nerve abnormalities. Proximal symmetric motor neuropathy is characterized by symmetrical pain in the lower limbs and thighs, as well as pain in the lower back and progressive myasthenia. Electromyography showed neurogenic damage.
Mononeuropathy and multiple mononeuropathy are based on diabetic microangiopathy. Pathologically, they are mainly focal vascular lesions at the site of nerve damage. The most common single neuropathy is oculomotor nerve involvement, but the pupil reflex is still normal. Secondly, the abducens nerve, trochlear nerve and trigeminal nerve were involved. The characteristic of single neuropathy is that it often occurs in diabetic patients over 50 years old, with poor blood glucose control, and other neuropathy is generally not obvious. Most of the patients had acute onset, accompanied by post orbital pain. Within one week before onset, there were often auras of headache, retroorbital pain, upper lip acupuncture or numbness. After the onset of the disease, the patient has obvious blepharoptosis and eye movement disorder, but the pupillary reflex is not involved, which helps to identify whether there is nerve compression disease.
matters needing attention
This disease often involves the proximal muscles of the lower extremities innervated by the femoral nerve, sciatic nerve and obturator nerve. Most of the patients were middle-aged and elderly patients with long-term poor control of diabetes, and most of them were male. The onset is acute, accompanied by asymmetric persistent muscle pain, muscle weakness and atrophy appear soon after the onset, but the general sensory impairment is not obvious. If treated effectively as soon as possible, the prognosis is good and can recover after 3-6 months.
