Generalized Peripheral Polyneuropathy

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Lead Author(s): 

Jonathan S. Kirschner, MD, RMSK
Se Won Lee, MD

Supporting Author(s): 

Sylvia I. Watkins-Castillo, PhD

Peripheral neuropathy is a condition that develops from a dysfunction of the nerves that transmit motor or sensory information to and from the brain, spinal cord and the rest of the body. An estimated 20 million people in the United States have some form of the more than 100 types of peripheral neuropathy.1,2 Peripheral neuropathy can be categorized as hereditary or acquired, with diabetes mellitus the most common cause of acquired peripheral neuropathy.1 Alcohol use is also a common cause.

Peripheral Neuropathy Related to Diabetes

Up to 70% of patients with diabetes eventually develop peripheral neuropathy, with symptoms ranging from subtle or no symptoms to tingling, pain, and profound weakness. Symptoms usually involve the longer (distal) nerves, affecting the toes, feet, then gradually progress up the body. Sensory symptoms are more common than motor, and pain occurs in 40-60% of patients with documented neuropathy.3

Other Peripheral Polyneuropathy

Guillan-Barre syndrome (GBS) is a peripheral neuropathy in which the body’s immune system attacks part of the peripheral nerve. The syndrome is rare, afflicting approximately one person in 100,000. Usually GBS occurs a few days or weeks after a respiratory or gastrointestinal viral infection. Less commonly it occurs following surgery, or vaccination. There has recently been an increased incidence of GBS due to infection from the Zika virus.  

Charcot-Marie-Tooth (CMT) is one of the most common inherited peripheral neuropathies, affecting 1 in 2500 people in the United States. It has several forms affecting different parts of the peripheral nervous system. Despite its inherited fashion, the onset of symptoms varies depending on the type and severity, and it can present in adulthood. Symptoms may involve the foot, lower leg and hand/finger with numbness, tingling, weakness and muscle wasting. Due to weakness, fatigue and impaired gait, quality of life is significantly impaired.4 Some patients with severe involvement are disabled.5

  • 1. a. b. Hanewinckel R, van Oijen M, Ikram MA, van Doorn PA. The epidemiology and risk factors of chronic polyneuropathy. Eur J Epidemiol 2016;31(1):5-20.
  • 2. National Institute of Neurological Disorders and Stroke Disorder Index. 2016.
  • 3. Callaghan BC, Cheng HT, Stables CL, et al. Diabetic neuropathy: clinical manifestations and current treatments. Lancet Neurol 2012;11(6):521-34.
  • 4. Cordeiro JL, Marques W, Hallak JEC, Osório FL. Charcot–Marie–Tooth disease, psychiatric indicators and quality of life: a systematic review. ASN NEURO 2014;6(3): e00145.
  • 5. Pfeiffer G, Wicklein EM, Ratusinski T, et al. Disability and quality of life in Charcot-Marie-Tooth disease type 1. J Neurol Neurosurg Psychiatry 2001;70(4):548-50.


  • Fourth Edition

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