Objective evidence for the reversibility of nerve injury in diabetic neuropathic cachexia.

mality in our patient, presumably reflecting the brainstem atrophy. Previously, bowel dysfunction has only rarely been documented in WFS (3,4). In our case, loss of SPRCs and sphincter weakness were the main bowel abnormalities. The SPRCs are likely to reflect the intrinsic neuronal activities of the pacemaker cells in the myenteric plexus, which can be damaged in peripheral neuropathies that involve small fibers. Sphincter tone is maintained by the extrinsic somatic nerve for the external sphincter and sympathetic nerve for the internal sphincter, respectively, which can also be damaged in peripheral neuropathies. These bowel dysfunctions need specific management to maximize the quality of life in patients with WFS. ZHI LIU, MD RYUJI SAKAKIBARA, MD TOMOYUKI UCHIYAMA, MD TATSUYA YAMAMOTO, MD TAKASHI ITO, MD SHOICHI ITO, MD YUSUKE AWA, MD TAKEO ODAKA, MD TAKETO YAMAGUCHI, MD TAKAMICHI HATTORI, MD