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Acute Painful Neuropathy (Insulin Neuritis) in a Boy Following Rapid Glycemic Control for Type 1 Diabetes Mellitus

Department of Neurology Indiana University School of Medicine Indianapolis, Indiana

Deborah K. Sokol, PhD, MD

Department of Neurology Indiana University School of Medicine Indianapolis, Indiana, dksokol{at}iupui.edu

Lisa H. Smith, MD

Department of Neurology Indiana University School of Medicine Indianapolis, Indiana

Riley J. Snook, MD

Department of Neurology Indiana University School of Medicine Indianapolis, Indiana

Steven G. Waguespack, MD

Department of Endocrine Neoplasia and Hormonal Disorders University of Texas M.D. Anderson Cancer Center Houston, Texas

John C. Kincaid, MD

Department of Neurology Indiana University School of Medicine Indianapolis, Indiana

We report a case of acute, painful polyneuropathy in a boy with newly diagnosed type 1 diabetes mellitus associated with a precipitous drop in hemoglobin A_1c. After initiation of insulin, the patient's hemoglobin A_1c dropped from 14.1 to 7.6%, and he developed severe pain in his feet, which prevented him from walking. Nerve conduction studies were consistent with mild to moderate sensorimotor peripheral neuropathy. Initially, he required opiate analgesics for pain control. Three months after presentation, the patient showed dramatic improvement and regained his ability to walk. Although not well described in the pediatric literature, this case represents insulin neuritis, one of the few diabetic neuropathies that has a favorable outcome. (J Child Neurol 2003;18:365—367).

Journal of Child Neurology, Vol. 18, No. 5, 365-367 (2003)
DOI: 10.1177/08830738030180051701


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