Table 2

Symptoms and signs of DSPN

Large myelinated nerve fibersSmall myelinated nerve fibers
FunctionPressure, balanceNociception, protective sensation
Symptoms§Numbness, tingling, poor balancePain: burning, electric shocks, stabbing
Examination (clinically diagnostic)**Ankle reflexes: reduced/absent Vibration perception: reduced/absent 10-g monofilament: reduced/absent Proprioception: reduced/absentThermal (cold/hot) discrimination: reduced/absent** Pinprick sensation: reduced/absent**
  • §To document the presence of symptoms for diagnosis;

  • **Documented in symmetrical, distal to proximal pattern.