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September 1937

CHANGES IN THE SPINAL CORD IN DIABETES MELLITUS: Report of a Case with Autopsy

Author Affiliations

Los Angeles

From the departments of Medicine and Neurology, College of Medical Evangelists, and the Cajal Laboratory of Neuropathology, Los Angeles County Hospital.

Arch NeurPsych. 1937;38(3):564-571. doi:10.1001/archneurpsyc.1937.02260210130009
Abstract

The neurologic complications of diabetes mellitus present themselves clinically as disturbances of sensory, motor, sphincter and trophic functions. The sensory disturbances are especially distressing to the patients. For example, Fitz1 found "rheumatic pains" or numbness and tingling to be the chief complaint in 14 per cent of two hundred and forty-nine cases, these symptoms being exceeded only by weakness or loss of weight (in 20 per cent) and urinary symptoms and thirst (in 21 per cent).

Although Kraus,2 on the basis of clinical evidence, concluded that nearly all the neurologic manifestations of diabetes mellitus are due to lesions in the spinal cord or nerve roots, degenerative changes are in fact more common in the peripheral nerves, the most advanced alterations being in their distal portions. The problem of peripheral neuropathy in diabetes has been thoroughly reviewed by Jordan.3

Three syndromes occur which point strongly to involvement of

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