874 - Mononeuritis Multiplex causing neuropathic pain of the uper limbs in a young Diabetic Patient

Case Diagnosis: We report the case of a 43 year-old female with history of type 1 diabetes mellitus for the past 8 years who presented in the outpatient clinic of physical medicine and rehabilitation (PMR) with disabling neuropathic pain of the right upper limb.

Case Description: The patient described persistent numbness, particularly at night, tingling sensation in the fingers and arm during the day and cervical pain.

Physical examination showed that the neck was stiff with a clear limited range of motion, particularly neck extension. The Adson manoeuver was negative however spurling,phalen and tinel tests were positive . Neurological exam revealed absence of osteotendinous reflexes with weakness in the the biceps brachii, brachioradialis, flexor digitorum. and abductor pollicis brevis .Electromyography confirmed Mononeuritis Multiplex by showing minimal, diffuse, sensory-motor peripheral multineuritis of all 4 limbs with a negative etiological work-up.cervical X-rays showed C6-C7 discopathy.

Discussions: Distal symmetric polyneuropathy is a well recognized complication of diabetes mellitus. Mononeuritis Multiplex is less frequent it is seen in elderly patients but is not a feature in young diabetics.

Conclusions: Distal symmetric polyneuropathy is a well recognized complication of diabetes mellitus. Mononeuritis Multiplex is less frequent it is seen in elderly patients but is not a feature in young diabetics.