Atypical presentation of Bruns-Garland Syndrome in a patient with metabolic comorbidities: a case report
Keywords:
AMIOTROFIA DIABÉTICA; NEUROPATÍA; NEUROPATÍA DIABÉTICA., DIABETIC NEUROPATHIES; NEUROPATHY; DIABETIC NEUROPATHIES., AMIOTROFIA DIABÉTICA; NEUROPATIA; NEUROPATIA DIABÉTICA.Abstract
Introduction: Bruns-Garland syndrome, or diabetic lumbosacral radiculoplexopathy, is an uncommon neurological complication of diabetes mellitus, with an estimated prevalence of less than 1 %. It is characterized by pain and weakness in the lower limbs, typically of asymmetric and progressive onset, and may be misdiagnosed as musculoskeletal or compressive pathology.
Case presentation: We report the case of a 61-year-old male with a history of arterial hypertension and poorly controlled type 2 diabetes, who presented with one month of left thigh pain followed by progressive weakness in both lower limbs, without other neurological symptoms. Physical examination revealed decreased muscle strength and paresthesias. Magnetic resonance imaging ruled out radicular compression. Electromyography demonstrated motor axonal denervation consistent with lumbosacral radiculoplexopathy. Treatment with pregabalin, amitriptyline, cytidine monophosphate, and physical therapy was initiated, with favorable clinical response.
Conclusions: This case illustrates an atypical presentation of Bruns-Garland syndrome, without weight loss or autonomic symptoms, which delayed its initial recognition. Early diagnosis based on clinical suspicion and neurophysiological studies is essential to avoid unnecessary interventions and improve the patient’s functional prognosis.
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