Painless Footdrop in a Child with Newly Diagnosed Type 1 Diabetes Mellitus: Case Report

Diabetic neuropathy is a major cause of morbidity among diabetics, usually affecting patients with long-standing diabetes and advancing age. We present a case of atypical first clinical presentation of diabetes mellitus type 1 in a pediatric patient. A 15-year-old male patient presented to the Emergency department with complaints of right foot weakness associated with mild paresthesia of 1-week duration. There were complaints of polyuria, polydipsia and weight loss in the same timeframe. On subsequent examination, the patient exhibited signs of right-sided foot drop with weak ankle dorsiflexion and eversion accompanied by impaired sensation over the dorsum of the right foot. Lab results confirmed a diagnosis of diabetes mellitus type 1 and the patient was started on subcutaneous insulin injections. The patient’s foot drop recovered within 1 month of insulin initiation. This case highlights that Type 1 diabetes mellitus can present atypically as acute onset neuropathy in pediatric patients, making it an important differential diagnosis.