Peripheral neuropathies: causes, clinical features, and modern approaches to treatment

Abstract

Peripheral neuropathies are a heterogeneous group of disorders caused by damage to peripheral nerves and can involve sensory, motor, and autonomic fibers. Common etiologies include metabolic disease (especially diabetes), nutritional deficiencies (notably vitamin B12), toxins and medications (e.g., chemotherapy), infections, hereditary neuropathies, compression/entrapment syndromes, and immune-mediated conditions such as Guillain–Barré syndrome and chronic inflammatory demyelinating polyneuropathy (CIDP). Clinical features vary by fiber type and pattern of involvement but often include distal symmetric numbness, tingling, burning neuropathic pain, weakness, reduced reflexes, gait imbalance, and autonomic symptoms (orthostatic intolerance, sweating or gastrointestinal disturbances).