• Matthew Silsby, Eva L Feldman, Richard D Dortch, Alison Roth, Simon Haroutounian, Yusuf A Rajabally, Steve Vucic, Michael E Shy, Anne Louise Oaklander, and Neil G Simon.
• Neurology, Westmead Hospital, Westmead, New South Wales, Australia.
• J. Neurol. Neurosurg. Psychiatr. 2023 Dec 1; 94 (12): 102510391025-1039.

AbstractDistal sensory polyneuropathy (DSP) is characterised by length-dependent, sensory-predominant symptoms and signs, including potentially disabling symmetric chronic pain, tingling and poor balance. Some patients also have or develop dysautonomia or motor involvement depending on whether large myelinated or small fibres are predominantly affected. Although highly prevalent, diagnosis and management can be challenging. While classic diabetes and toxic causes are well-recognised, there are increasingly diverse associations, including with dysimmune, rheumatological and neurodegenerative conditions. Approximately half of cases are initially considered idiopathic despite thorough evaluation, but often, the causes emerge later as new symptoms develop or testing advances, for instance with genetic approaches. Improving and standardising DSP metrics, as already accomplished for motor neuropathies, would permit in-clinic longitudinal tracking of natural history and treatment responses. Standardising phenotyping could advance research and facilitate trials of potential therapies, which lag so far. This review updates on recent advances and summarises current evidence for specific treatments.© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

9 keywords...

hide…