Advances in diagnosis and management of distal sensory polyneuropathies.
Silsby, Matthew Feldman, Eva L Dortch, Richard D Roth, Alison Haroutounian, Simon Rajabally, Yusuf A Vucic, Steve Shy, Michael E Oaklander, Anne Louise Simon, Neil G
Silsby, Matthew
Feldman, Eva L
Dortch, Richard D
Roth, Alison
Haroutounian, Simon
Rajabally, Yusuf A
Vucic, Steve
Shy, Michael E
Oaklander, Anne Louise
Simon, Neil G
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2023-03-30
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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 fa
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Silsby M, Feldman EL, Dortch RD, Roth A, Haroutounian S, Rajabally YA, Vucic S, Shy ME, Oaklander AL, Simon NG. Advances in diagnosis and management of distal sensory polyneuropathies. J Neurol Neurosurg Psychiatry. 2023 Mar 30:jnnp-2021-328489. doi: 10.1136/jnnp-2021-328489. Epub ahead of print.
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