Hassan G. Nassar, Ehab S. Mohamed, Ahmed El Shamy,

Ehab A. El-Seidy, Hazem A. Fayed, Yasser A. ElHeneedy

Department of Neurology, Tanta University; Egypt

Background: The most common type of diabetic neuropathy is symmetrical distal mainly sensory polyneuropathy, but we recognize a type of neuropathy similar to chronic inflammatory demyelinating polyneuropathy (CIDP) occurring in diabetics. Objective: Study clinical, electrophysiological and laboratories clues to differentiate between diabetic neuropathy and CIDP like syndrome. Methods: Group A, include 26 patients (16 male and 10 female) with mean age 54.5±7.3 had diabetic polyneuropathy. Group B, include 9 diabetic patients with CIDP like syndrome (6 male and 3 female) with mean age 58.5±8.6. Motor nerve conduction study of median, ulnar, tibial and peroneal nerves, sensory nerve conduction study of median, ulnar and sural nerves were examined. F-waves of median, ulnar, tibial and peroneal nerves were calculated. Lumber puncture was done for cerebrospinal fluid protein level. Results: Group A showed 61.5% of patients had progressive sensory motor neuropathy while 88.8% in group B showed subacute motor neuropathy. There were significant differences between two groups as regard DML, MNCV, and F-wave (P-values were 0.001, 0.008 and 0.001 respectively). There was no significant difference as regard non-recordable compound muscle action potential (CMAP) between two groups. Conduction block was present in 80% of patients with CIDP like neuropathy (P=0.001). There was significant elevation of CSF proteins in patient with CIDP like neuropathy. Conclusion; There is type of neuropathy developed in diabetics had the following characters, subacute onset, progressive weakness with electrophysiological findings of demyelination and elevation of CSF protein. [Egypt J Neurol Psychiat Neurosurg.  2015; 52(1): 15-19]

 Keywords: Diabetic neuropathy, CIDP like syndrome.