Most common causes of symmetrical neuropathy Disease Prevalence 11-41% (depending on Diabetes1 2 duration, type, and control of diabetes) Paraproteinaemia2 3 9-10% Alcohol misuse1 7% Renal failure1 4% Vitamin B-12 deficiency1 3.6% 16%, but depends on the HIV infection1 population studied and is usually much lower 10-40% of different Chronic idiopathic axonal neuropathy4 hospital series Table 2 Initial investigations of symmetrical neuropathy Test Detects Fasting blood glucose/ HBa1c Diabetes Occult alcohol misuse; Liver function systemic disease Occult alcohol misuse; Full blood count systemic disease Erythrocyte sedimentation rate Systemic disease Serum creatinine Renal failure Thyroid stimulating hormone Myxoedema concentration Serum protein immunofixation Serum paraprotein electrophoresis Vitamin B-12 Vitamin B-12 deficiency HIV serology (in at risk patients) HIV infection
Most common causes of symmetrical neuropathy Disease Prevalence Diabetes1 2 11-41% (depending on duration, type, and control of diabetes) Paraproteinaemia2 3 9-10% Alcohol misuse1 7% Renal failure1 4% Vitamin B-12 deficiency1 3.6% HIV infection1 16%, but depends on the population studied and is usually much lower Chronic idiopathic axonal neuropathy4 10-40% of different hospital series Table 2 Initial investigations of symmetrical neuropathy Test Detects Fasting blood glucose/ HBa1c Diabetes Liver function Occult alcohol misuse; systemic disease Full blood count Occult alcohol misuse; systemic disease Erythrocyte sedimentation rate Systemic disease Serum creatinine Renal failure Thyroid stimulating hormone concentration Myxoedema Serum protein immunofixation electrophoresis Serum paraprotein Vitamin B-12 Vitamin B-12 deficiency HIV serology (in at risk patients) HIV infection