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Pattern-Recognition Approach to Peripheral Neuropathy

Symmetric proximal and distal weakness with sensory loss GBS, CIDP
Symmetric distal weakness with sensory loss Drug-induced, toxic, and metabolic neuropathies; hereditary neuropathies; amyloidosis
Asymmetric distal weakness with sensory loss - multiple nerves Vasculitis; HHNPP; infections such as leprosy, Lyme disease, sarcoidosis, and HIV
Asymmetric distal weakness with sensory loss - single nerve Compressive mononeuropathy and radiculopathy
Asymmetric distal weakness without sensory loss Motor neuron disease, multifocal motor neuropathy
Asymmetric proximal and distal weakness with sensory loss Polyradiculopathy or plexopathy, meningeal carcinomatosis or lymphomatosis, HNPP, hereditary neuropathies
Symmetric sensory loss without weakness Crytogenic sensory polyneuropathy; metabolic, drug-induced, or toxic neuropathies; leprosy
Asymmetric proprioceptive sensory loss without weakness Sensory neuronopathies (ganglionopathies); consider paraneoplastic, Sjogren syndrome, vitamin B6 toxicity, HIV-related sensory neuronopathies, cis-platinum toxicity
Autonomic symptoms and signs Diabetes mellitus, amyloidosis, GBS, vincristine, porphyria, HIV-related autonomic neuropathy, idiopathic pandysautonomia
Created by: megankirch