An easy approach to evaluating peripheral neuropathy

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J Fam Pract. 2006 Oct;55(10):853-61.

An easy approach to evaluating peripheral neuropathy.

Burns JM, Mauermann ML, Burns TM.

University of Virginia Health System Department of Neurology, Box

800394, Charlottesville, VA 22908 USA.

Pain described by patients as electric shocks, burning, freezing,

tightness, or throbbing suggests toxic, metabolic, or ischemic causes

of neuropathy. When motor and sensory symptoms appear together, rank

them in order of symptom predominance. Motor symptom supremacy may

indicate an immune-related disorder. When measuring sensory thresholds,

keep in mind that they normally increase with the patient's age and

height. Vibration sensation in the toes of elderly persons is often

said to be decreased, when in fact it is only an age-related change.