Table 1.

Patterns for peripheral neuropathy and related diagnoses⁶

Pattern no.	Neurological involvement	Causes
1.	Symmetric proximal and distal weakness with sensory loss	Chronic inflammatory demyelinating polyneuropathy. Guillain-Barre syndrome.
2.	Symmetric distal sensory loss with or without distal weakness	Cryptogenic sensory polyneuropathy. Metabolic disorders. Drugs, toxins. Hereditary (Charcot-Marie-Tooth, amyloidosis and others).
3.	Asymmetric distal weakness with sensory loss	Multiple nerves, consider: vasculitis. Hereditary neuropathy with liability to pressure palsies. Multifocal acquired demyelinating sensory and motor neuropathy. Infectious (leprosy, lyme, sarcoid, HIV). Single nerve/nerve root: compressive mononeuropathy and radiculopathy.
4.	Asymmetric proximal and distal weakness with sensory loss	Polyradiculopathy or plexopathy due to diabetes mellitus. Meningeal carcinomatosis or lymphomatosis, sarcoidosis, amyloidosis, Lyme, idiopathic, hereditary. Hereditary neuropathy with liability to pressure palsy.
5.	Asymmetric distal weakness without sensory loss	With upper motor neuron findings Motor neuron disease/ALS/PLS (amyotrophic lateral sclerosis, primary lateral sclerosis). Without upper motor neuron findings Progressive muscular atrophy (brachial amyotrophic diplegia or leg amyotrophic diplegia). Multifocal motor neuropathy. Multifocal acquired motor axonopathy. Juvenile monomelic amyotrophy.
6.	Symmetric sensory loss and distal areflexia with upper motor neuron findings	B12 deficiency and other causes of combined system degeneration with peripheral neuropathy. Copper deficiency (including zinc toxicity). Inherited disorders (adrenomyeloneuropathy, MLD, Friedreich’s).
7.	Symmetric weakness without sensory loss	Proximal and distal weakness Spinal muscular atrophy. Distal weakness Hereditary motor neuropathy.
8.	Focal midline proximal symmetric weakness	Neck extensor weakness Amyotrophic lateral sclerosis. Bulbar weakness Amyotrophic lateral sclerosis (ALS). Primary lateral sclerosis (PLS).
9.	Asymmetric proprioceptive sensory loss without weakness	Sensory neuronopathy (ganglionopathy). Chronic immune sensory polyradiculopathy.
10.	Autonomic symptoms and signs	Hereditary sensory autonomic neuropathy. Diabetes. Guillain-Barre syndrome. Amyloid disease. Porphyria. Fabry’s disease.