Cryptogenic sensory and sensorimotor polyneuropathies

Chronic sensory or sensorimotor polyneuropathy is a common clinical problem referred to neurologists. Even with modern diagnostic approaches, up to on e-third of them will remain unclassified. Recent studies have provided insi ght into their clinical spectrum and course. The age of onset tends to be i n the sixth to seventh decade of life. Symptoms progress slowly, and most p atients present with paresthesias or pain. Cryptogenic polyneuropathies are almost exclusively axonal on clinical, electrophysiologic, and histologic grounds. Overall, the prognosis is favorable, and only a small minority of patients develop significant motor disability or physical incapacitation. P rogression to a nonambulatory state essentially never occurs. Successful ma nagement should focus on rational pharmacotherapy for painful paresthesias combined with patient education and reassurance.