Manifestations depend on whether it involves sensory, motor, or autonomic fibres
Physical examination should include pinprick and temperature (small fibre), vibration and proprioception (large fibre), and mucle bulk, tone, power, and reflexes
Large fibre sensory dysfunction can cause loss of proprioception and gait impairment, as well as numbness and paresethesias
Includes gait ataxia from loss of proprioception
Small fibre sensory dysfunction can cause pain (most often), hyperesthesia, or allodynia, as well as numbness and paresethesias
Can also cause areas of redness and swelling during the episodes of pain
Can also cause deep aching, postexertional malaise, and neuropathic itch
Motor dysfunction can cause weakness, loss of dexterity, gait disturbance
Autonomic dysfunction can cause orthostatic intolerance, gastroparesis, constipation, diarrhea, neurogenic bladder, sexual dysfunction, pupillomotor symptoms (including burry vision), and vasomotor symptoms (including dry eyes, mouth, and skin, and burning and flushing skin)
Distal Symmetric Polyneuropathy
Most common subtype
Length-dependent process
Symmetric distal weakness with sensory loss and decreased Achilles reflex, ascending from the feet and then once it reaches the mid-calf, also including the fingers (glove and stocking)
