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Signs and Symptoms

The symptoms of neuropathy depend upon the type of nerve(s)—sensory, motor, or autonomic—affected.

Symptoms of peripheral neuropathy typically start with numbness, prickling, or tingling in the toes or fingers. These sensations may spread to the feet or hands and cause burning, freezing, throbbing, and/or shooting pain that is often worse at night. The pain may be constant or may come and go. The onset of neuropathy may be sudden or it may develop gradually.

When motor nerves are affected, signs and symptoms may include:

  • Muscle weakness, cramping, and/or twitching
  • Muscle wasting (atrophy)
  • Loss of reflexes

Sensory nerve damage can cause the following symptoms:

  • A sensation or wearing invisible gloves or socks
  • Loss of reflexes and "position sense," which affects coordination and balance
  • Extreme sensitivity to touch, even with very light pressure (such as from a bed sheet)
  • Decreased ability to detect touch, pressure, temperature, and vibration

If autonomic nerves are affected, signs and symptoms may include:

  • Blurred vision; slow pupil reaction, which affects night vision
  • Decreased or excessive sweating and heat intolerance
  • Difficulty swallowing or breathing
  • Dizziness and fainting when standing due to low blood pressure
  • Erectile dysfunction in males; vaginal dryness in females
  • Heart rate that does not change appropriately with exercise
  • Incontinence and difficulty urinating and emptying the bladder
  • Lack of awareness of low blood glucose
  • Altered movement of food through the gastrointestinal tract, leading to constipation or diarrhea, abdominal pressure and bloating, nausea, heartburn

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