Peripheral neuropathy, acquired and hereditary
Pattern recognition (length-dependent, demyelinating, small fibre, ganglionopathy, mononeuritis multiplex), reading nerve conduction studies, diabetic and chemotherapy neuropathy, paraproteins and amyloid, Charcot-Marie-Tooth and HNPP, and foot protection.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Polyneuropathy affects 2 to 8% of adults, more with age. Diabetes and prediabetes cause about a third, alcohol and chemotherapy many more, and a quarter remain idiopathic after full work-up.
- Pattern and tempo narrow the list more than any test. Most chronic, length-dependent, sensory-predominant axonal neuropathies are diabetic, toxic, nutritional or idiopathic.
- Red flags for something treatable: asymmetry, proximal weakness, motor predominance, rapid progression, arm onset, demyelination on studies.
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Sources
- Practice parameter: evaluation of distal symmetric polyneuropathy: role of laboratory and genetic testingEngland JD et al., American Academy of Neurology, Neurology 2009;72(2):185-192, 2009
- Oral and topical treatment of painful diabetic polyneuropathy: practice guideline update summaryPrice R et al., American Academy of Neurology, Neurology 2022;98(1):31-43, 2022
- Standards of Care in Diabetes 2026: Retinopathy, neuropathy and foot careAmerican Diabetes Association, Diabetes Care 2026;49(Suppl 1), 2026
- Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: ASCO guideline updateLoprinzi CL et al., Journal of Clinical Oncology 2020;38(28):3325-3348, 2020
- Australian evidence-based guidelines for diabetes-related foot diseaseAU/NZDiabetes Feet Australia, 2021
- Therapeutic Guidelines: Neurology (peripheral neuropathy)AU/NZTherapeutic Guidelines Limited
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy