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Multifocal fiber degeneration and loss

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Transverse semithin epoxy sections of sural nerve. Upper panel: Low-magnification view showing that most fascicles are devoid of myelinated fibers whereas other fascicles are more intact. Lower panel: Higher-power view of the area within the inset in the upper panel. The left fascicle shows an admixture of normal and actively degenerating fibers; the right fascicle is essentially devoid of myelinated fibers, and only rare degenerating profiles remain. These findings are similar in the diabetic and nondiabetic conditions. Methylene blue staining. (Dyck PJ, Windebank AJ. Diabetic and nondiabetic lumbosacral radiculoplexus neuropathies: new insights into pathophysiology and treatment. Muscle Nerve 2002;25:477-91. Reprinted with permission of John Wiley & Sons, Inc.)