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Symmetric Peripheral Neuropathy

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Symmetric Peripheral Neuropathy, Polyneuropathy, Stocking Glove Peripheral Neuropathy, Stocking-Glove Neuropathy

  • See Also
  1. Peripheral Neuropathy
  2. Mononeuropathy
  3. Acute Motor Weakness Causes
  4. Drug-Induced Polyneuropathy
  • Causes
  • Symmetric Proximal Motor Neuropathy (Type 1)
  1. Characteristics
    1. Symmetric proximal Muscle atrophy and weakness
  2. Acute Inflammatory Demyelinating Polyneuropathy (Guillain-Barre Syndrome)
    1. Guillain-Barre Syndrome typically starts in the distal extremities (esp. legs) and ascends
  3. Chronic Inflammatory Demyelinating Polyneuropathy
  4. Primary Myelinopathy
  5. Hypothyroidism(
  6. Diabetes Mellitus
  7. Lyme Disease
  8. Diphtheria
  9. Malignancy
  10. HIV or AIDS
  11. Hepatitis B
  12. Buckthorn
  13. Vincristine
  14. Acute Arsenic Poisoning
  • Causes
  • Symmetric Distal sensorimotor Polyneuropathy or DSPN (Type 2)
  1. Characteristics
    1. Stocking Glove Peripheral Neuropathy is primarily sensory (numbness, tingling or burning Sensation)
    2. Symmetric distal sensory (pain, Paresthesias, proprioception, autonomic) and motor (weakness, atrophy) Neuropathy
  2. Common
    1. Diabetic Neuropathy (Diabetic DSPN)
    2. Alcoholism induced Neuropathy (Alcoholic DSPN)
    3. HIV Infection or AIDS
    4. Malignancy (Paraneoplastic Syndrome)
  3. Toxins
    1. Acrylamide
    2. Allyl chloride
    3. Carbon disulfide
    4. Carbon Monoxide
    5. Ethylene oxide
    6. Hexacarbons
    7. Trichloroethylene
    8. OPIDP, PCBs, PNU
    9. Organophosphates
    10. Nitrous Oxide Abuse (due to secondary Vitamin B12 Deficiency)
  4. Heavy Metal Poisoning
    1. Arsenic
    2. Lead Poisoning
    3. Gold
    4. Mercury
    5. Thallium
  5. Medications
    1. See Drug-Induced Polyneuropathy
  6. Vitamin Deficiency
    1. Thiamine deficiency (Beriberi)
    2. Niacin Deficiency (Pellagra)
    3. Vitamin B12 Deficiency (Pernicious Anemia)
    4. Nitrous Induced Subacute Combined Degeneration of the Spinal Cord
    5. Vitamin B6 deficiency
    6. Trace Element Deficiency (e.g. Copper deficiency)
    7. Folate Deficiency
  7. Paraproteinemia
    1. Amyloidosis
    2. Multiple Myeloma
    3. Waldenstrom's Macroglobulinemia
  8. Miscellaneous causes
    1. Acromegaly
    2. Charcot-Marie-Tooth
    3. Chronic lung disease
    4. Hypothyroidism
    5. Chronic Kidney Disease
    6. Porphyria
    7. Cryoglobulinemia
    8. Chronic Liver Disease
    9. Guillain-Barre Syndrome (initially distal, and progresses proximally)
    10. Tic Paralysis
    11. Leprosy
    12. Lyme Disease
    13. Celiac Disease
    14. Connective Tissue Disorder or Vasculitis (e.g. Systemic Lupus Erythematosis)
    15. Rheumatoid Arthritis
    16. Gouty Neuropathy
    17. Whipple Disease
  • References
  1. Gallagher in Marx (2002) Rosen's Emergency Med, p. 1506
  2. Pryse-Phillips in Noble (2001) Primary Care, p. 1579
  3. Castelli (2020) Am Fam Physician 102(12): 732-9 [PubMed]