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Sensory neuropathies, from symptoms to treatment

Botez, Stephan Aa; Herrmann, David Nb

doi: 10.1097/WCO.0b013e32833c7a19
Nerve, neuro-muscular junction and motor neuron diseases: Edited by Emma Ciafaloni

Purpose of review The present review focuses on recent developments in diagnosis and treatment of sensory neuropathies. It does not seek to establish a comprehensive classification of sensory neuropathies, nor treatment guidelines per se.

Recent findings Diagnostic criteria and guidelines have been developed for distal symmetric polyneuropathies, small fiber sensory neuropathies and sensory neuronopathies. Novel diagnostic tools such as skin biopsies now allow diagnosis of small fiber sensory neuropathies. Genetic testing has defined new subtypes of mitochondrial neuropathies and inherited neuropathies with sensory involvement. Intravenous immunoglobulin and tumor necrosis factor-α inhibitors show promise for some dysimmune sensory neuropathies or neuronopathies. Additional options for management of neuropathic pain are emerging.

Summary Diagnostic methods for both acquired and hereditary sensory neuropathies have progressed in recent years, leading to earlier and more specific diagnoses and a better understanding of disease mechanisms. Much progress remains to be made regarding symptomatic and disease-modifying therapy for a range of sensory neuropathies, including those due to diabetes, HIV infection and from dysimmune or hereditary causes.

aDepartment of Neurology, Centre de Recherche du CHUM, Montreal, Quebec, Canada

bDepartment of Neurology and Pathology, University of Rochester, Rochester, New York, USA

Correspondence to David N. Herrmann, MBBCh, Department of Neurology and Pathology, Box 673, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY 14642, USA Tel: +1 585 275 4568; fax: +1 585 273 1254; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.