Symptoms:

Digestive tract:

• Constipation
• Diarrhea
• Nausea and vomiting
• Swallowing difficulty

Legs and arms:

• Deep pain, most commonly in the feet and legs
• Loss of the sense of warm or cold
• Muscle cramps
• Numbness (if the nerves are severely damaged, you may be unaware that a blister or minor wound has become infected)
• Tingling or burning sensation in the extremities, particularly the feet
• Weakness

Other symptoms:

• Dizziness
• Drooping eyelid
• Drooping face
• Drooping mouth
• Impotence
• Light-headedness when standing up (orthostatic hypotension)
• Loss of bladder control
• Rapid heart rate
• Speech impairment
• Vision changes

Note: Symptoms vary depending on the nerve(s) affected, and may include symptoms other than those listed. Symptoms usually develop gradually over years.

Signs and tests:

Physical examination, including nervous system (neurological) and sensory tests, may diagnose neuropathies. A common early finding is the absence of ankle reflexes.

Health care providers often test for loss of sensation in the feet with a brush-like instrument called a monofilament.

Electrodiagnostic testing may be done.