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It usually begins in the hands and feet and may progress to the arms and legs and sometimes to other parts of the body where it may affect the autonomic nervous system. It may be acute or chronic. A number of different disorders may cause polyneuropathy, including diabetes and some types of Guillain–Barré syndrome. [4] [5] [6]
Peripheral neuropathy may first be considered when an individual reports symptoms of numbness, tingling, and pain in feet. After ruling out a lesion in the central nervous system as a cause, a diagnosis may be made on the basis of symptoms, laboratory and additional testing, clinical history, and a detailed examination.
CIPN involves various symptoms such as tingling, pain, and numbness in the hands and feet. [2] These symptoms can impair activities of daily living, such as typing or dressing, reduce balance, and increase risk of falls and hospitalizations. They can also give cause to reduce or discontinue chemotherapy.
The sensory changes can be a feeling of numbness or a tingling, pain rarely occurs in the hand. Complaints of pain tend to be more common in the arm, up to and including the elbow area, which is probably the most common site of pain in an ulnar neuropathy. [1] [2]
Paresthesias are usually painless and can occur anywhere on the body, but most commonly occur in the arms and legs. [1] The most familiar kind of paresthesia is the sensation known as "pins and needles" after having a limb "fall asleep". A less well-known and uncommon paresthesia is formication, the sensation of insects crawling on the skin.
Diabetes most commonly causes damage to the long nerves that supply the feet and lower legs, causing numbness, tingling and pain (diabetic polyneuropathy). Although these symptoms may also be present, the pain and weakness of proximal diabetic neuropathy often onset more quickly and affect nerves closer to the torso. [citation needed]
Chemotherapy-induced peripheral neuropathy is a progressive, enduring and often irreversible tingling numbness, intense pain, and hypersensitivity to cold, beginning in the hands and feet and sometimes involving the arms and legs caused by some chemotherapy agents. [7]
The diagnosis is considered in people who develop pain or numbness in a leg or foot with a history of diabetes. Muscle weakness, pain, balance loss, and lower limb dysfunction are the most common clinical manifestations. [7] Physical exam findings may include changes in appearance of the feet, presence of ulceration, and diminished ankle reflexes.