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What are the symptoms of peripheral neuropathy?
The symptoms of peripheral neuropathy somewhat depend on the cause. Typically, peripheral neuropathy affects the nerves of sensation. As a result, patients affected by peripheral neuropathy develop pain, burning, or tingling in the distribution of the affected nerves. Most commonly this is in the feet and/or hands. This can cause tingling, numbness, and/or burning in the toes or fingers.
When shingles causes peripheral neuropathy, the particular nerve affected causes a very localized burning and itching sensation. This could be, for examples, in the side of the chest, the face, the buttock, etc.
How is peripheral neuropathy diagnosed?
Because peripheral neuropathy has so many causes and so many presentations, the first step to diagnosis is performing a thorough medical history and physical examination. Certain tests done during the physical exam, including vibration and monofilament testing, are very accurate in diagnosing certain types of peripheral neuropathy, such as large fiber peripheral neuropathy seen with diabetes. Blood tests for exposure to toxins and electrodiagnostic studies, such as nerve conduction studies (NCS) and electromyelography (EMG) are also very useful, although these tests will not help with the diagnosis of small fiber neuropathy. Either skin biopsies or quantitative sudomotor axon reflex testing (QSART) are occasionally used to help diagnose small fiber neuropathy.