Diabetic Amyotrophy (Bruns-Garland Syndrome): A Narrative Review

BACKGROUND AND AIMS: Bruns-Garland syndrome (BGS) continues to be a contentious topic even 100 years after its discovery. Its lifelong incidence is 1% amongst diabetic individuals and affects middle aged-elderly individuals with type 2 diabetes mellitus (usually not poorly controlled). METHODS: The data presented in this review was collated from studies published on PubMed, MEDLINE and Google Scholar in October 2021. The search words included: “Bruns-Garland syndrome”, “diabetic amyotrophy” and “diabetic lumbosacral radiculoplexus neuropathy” and “proximal diabetic neuropathy”. RESULTS: The exact pathophysiology is debatable but an ischemic pathology (non-systemic microvasculitis) is most plausible. Its cardinal symptoms include acute onset of severe proximal lower extremity pain followed by weakness and wasting, some sensory loss, weight loss and autonomic symptoms. CONCLUSION: The prognosis is good as most patients improve to near- normal strength with pain cessation within 18 months of onset.