DeJong R N
Postgrad Med. 1977 Jan;61(1):101-7. doi: 10.1080/00325481.1977.11714510.
The neurologic manifestations most frequently described in association with diabetes are caused by involvement of the peripheral nerves and nerve roots. Whether there is also a specific central nervous system involvement has not been well documented. Pseudotabes diabetica and diabetic amyotrophy probably can be explained on the basis of severe neuropathy or radiculopathy. According to fairly recent studies, however, both myelopathy and encephalopathy may be part of the diabetic process. In the cases of myelopathy, there are degeneration of the long tracts and areas of demyelination with gliosis, as well as microinfarcts. In the cases of encephalopathy, there are degeneration of ganglion cells and nerve fibers in the cerebrum, brain stem, and cerebellum; cell loss, demyelination and gliosis; and infarction secondary to severe angiopathy.
与糖尿病相关的最常描述的神经学表现是由周围神经和神经根受累引起的。是否也存在特定的中枢神经系统受累尚未得到充分记录。糖尿病性假脊髓痨和糖尿病性肌萎缩可能可以基于严重的神经病变或神经根病来解释。然而，根据最近的研究，脊髓病和脑病都可能是糖尿病病程的一部分。在脊髓病病例中，存在长束变性、脱髓鞘区域伴胶质细胞增生以及微梗死。在脑病病例中，大脑、脑干和小脑中的神经节细胞和神经纤维发生变性；细胞丢失、脱髓鞘和胶质细胞增生；以及严重血管病变继发的梗死。
