[Neuropathy of the lower legs and feet in acute intermittent porphyria. A comparison of patients with type 1 diabetes and patients with AIP].

Distal neuropathy was assessed in 339 patients with acute intermittent porphyria (AIP). The chronic neurological signs were symmetrical and similar to those in Type 1 diabetic patients. Significant impairment was found concerning perception, extensor digitorum brevis test, lower leg pain, ankle and knee tendon reflexes but not concerning dry feet, loss of forefoot arch and hammer toes, when comparing patients with manifest vs. latent AIP. The neurological signs were more severe in the diabetic patients (n = 298). Five AIP patients had permanent quadriplegia and renal failure after severe attacks. Patients with manifest AIP had significantly more signs of distal chronic, symmetrical neuropathy of axonal type than had patients with latent AIP. More serious neurological lesions appear to develop after severe attacks.