Sensory disturbances:
Sensory examination important component of neurological examination.
First signs in peripheral neuropathy are usually sensory disturbances
Usually starts with involving the toes, distal foot and plantar surface (the classical ‘glove-and-stocking’ distribution) – usually symmetric.
Negative sensory symptoms – loss of sensation (small and/or large fibre); loss of proprioceptive and discriminatory sensation.
Positive sensory symptoms – parathesias; neuropathic pain
Allodynia – distortion of all sensation as painful
Hyperalgesia – increased areas of sensitivity to painful stimuli
Hyperpathia – increased pain threshold with a disproportionate increase in perceived pain when the threshold is crossed
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