Abstract:

Diabetes mellitus is a global public health issue impairing the quality of the patient’s life and it is also the most frequent cause of neuropathy. The diagnostic approach begins with the consolidation of the results obtained from the anamnesis, the patient’s medical history and his/her neurological examination. Hyperglycemia poorly managed throughout the years leads to numerous complications, especially vascular (microvascular, macrovascular) ones. We are describing here the case of a 53-year old female patient, with significant cardiac pathology (high blood pressure, permanent atrial fibrillation), who has been suffering from obesity and diabetes mellitus for approximately ten years, under treatment with oral antidiabetics, in whom we see the sudden installation of a state of postural instability and language impairments. In the brain CT scan, an ischemic stroke is shown in the vertebrobasilar area. Apart from the neurological pathology, which includes motor disorders in the right hemibody with ataxia, mainly expressive aphasia, diplopia, the patient has also developed in time, at approximately 18 years after the installation of diabetes mellitus, a sensory-motor polyneuropathy, with edemas in the lower parts, blisters and superficial ulcerations in the right leg. Diabetic neuropathy occurs following the nervous ischemia in the microvascular disease and it can be seen in several forms: symmetric polyneuropathy, autonomic neuropathy, mononeuropathies, cranial neuropathies and radiculopathies. Chronic diabetes complications generate the increase of the morbidity and mortality rates – diabetes mellitus is one of the main risk factors of stroke.

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