Journal article
Advances in diagnosis and management of distal sensory polyneuropathies
Journal of neurology, neurosurgery and psychiatry, Vol.94(12), pp.1025-1039
12/2023
DOI: 10.1136/jnnp-2021-328489
PMCID: PMC10544692
PMID: 36997315
Abstract
Distal 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.
Details
- Title: Subtitle
- Advances in diagnosis and management of distal sensory polyneuropathies
- Creators
- Matthew Silsby - Westmead HospitalEva L Feldman - University of MichiganRichard D Dortch - Vanderbilt UniversityAlison Roth - Barrow Neurological InstituteSimon Haroutounian - Department of Anesthesiology, Washington University School of Medicine in Saint Louis, St Louis, Missouri, USAYusuf A Rajabally - Aston UniversitySteve Vucic - The University of SydneyMichael E Shy - University of IowaAnne Louise Oaklander - Harvard Medical SchoolNeil G Simon - Macquarie University
- Resource Type
- Journal article
- Publication Details
- Journal of neurology, neurosurgery and psychiatry, Vol.94(12), pp.1025-1039
- DOI
- 10.1136/jnnp-2021-328489
- PMID
- 36997315
- PMCID
- PMC10544692
- NLM abbreviation
- J Neurol Neurosurg Psychiatry
- ISSN
- 0022-3050
- eISSN
- 1468-330X
- Publisher
- BMJ Publishing Group Ltd
- Grant note
- NA / Charcot-Marie-Tooth Association (http://dx.doi.org/10.13039/100002721) R01DK130913; R01NS093653; R24DK082841 / National Institutes of Health (http://dx.doi.org/10.13039/100000002) 1024915; 2001261 / National Health and Medical Research Council (http://dx.doi.org/10.13039/501100000925) 5-COE-2019-861-S—B / Juvenile Diabetes Research Foundation (http://dx.doi.org/10.13039/100008664) NA / Barrow Neurological Institute (http://dx.doi.org/10.13039/100013014) NA / Muscular Dystrophy Association (http://dx.doi.org/10.13039/100005202) GW140169; PR211292; W81XWH2110736 / U.S. Department of Defence R01NS104500-01; R01NS105755; U01 NS1094301 / National Institute of Neurological Disorders and Stroke (http://dx.doi.org/10.13039/100000065) R21 TR003312; U54NS065712 / National Center for Advancing Translational Sciences (http://dx.doi.org/10.13039/100006108)
- Language
- English
- Electronic publication date
- 03/30/2023
- Date published
- 12/2023
- Academic Unit
- Neurology; Molecular Physiology and Biophysics; Iowa Neuroscience Institute
- Record Identifier
- 9984381133902771
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