Assessment and Diagnosis
Clinical Presentation ÎSymmetrical stocking-and-glove pattern of pain or paresthesia in feet (usually involves lower limbs first, later hands), described variously as:
> Burning > Itching > Severe aching or throbbing > Shooting > Tearing > Toothache-like
ÎMay be accompanied by: > Absence of symptoms (eg, numbness, feeling "dead") > Pain evoked by ordinarily nonpainful stimuli (allodynia) OR
> Extreme sensitivity to painful stimuli (hyperalgesia)
ÎInsidious onset over period of time ÎTending to be worse at night
Nondiabetic Neuropathic Pain ÎPronounced motor signs ÎAsymetrical distribution of symptoms ÎNo diagnosis of diabetes ÎPossible causes: > Metastatic disease > Infection > Toxic substances > Condition(s) suggested by patient history
