Neuropathy of Diabetes Mellitus

This experiences of the internist, the neurosurgeon, and the neuropathologist. It demonstrates some of the clinical symptoms and signs which diabetes mellitus may assume. To a certain degree, diabetic neuropathy is a diagnosis of exclusion. When a neuropathy exists in a patient with diabetes, a cause-and-effect relationship to the diabetes should be considered first. However, the patient should have as careful an evaluation of the central and peripheral nervous system as the nondiabetic patient. The converse is also true—a neurological problem, particularly of the peripheral variety, might be the first indication of diabetes, and appropriate investigations should be done. There have been few postmortem examinations in early stages of diabetic neuropathy; therefore most of the reports are concerned with severe forms of the disease. Fraser and Bruce (1895)1found segmental degeneration of the myelin, but preservation of the continuity of the axons. Woltman and Wilder (1929)2described diffuse