Symptoms:

• Numbness
• Abnormal sensations; "pins and needles"
• Painful sensations
• Muscle weakness
• Muscle cramps or muscle aches
• Heat intolerance, especially after exercise
• Impotence (in men)
• Difficulty urinating
  • Incontinence (leaking urine)
  • Feeling of incomplete bladder emptying
  • Difficulty beginning to urinate
• Constipation
• Diarrhea
• Nausea, vomiting

Additional symptoms that may be associated with this disease:

• Swallowing difficulty
• Speech impairment
• Loss of muscle function or feeling
• Muscle contractions or spasm
• Muscle atrophy
• Movement, dysfunctional

Note: Changes in muscle strength or sensation usually occur on both sides of the body and are more common in the legs than in the arms. Symptoms may develop gradually and slowly become worse over time.

Signs and tests:

Results of a neurological exam may be abnormal. The person may have reduced reflexes signs of local nerve problems. Neurological problems usually affect both sides of the body.

An eye exam may show decreased pupil response or other problem. Blood pressure may fall when the person rises to a standing position.

Alcoholism is a risk factor for nutritional deficiency. Nutritional studies may show deficiencies of thiamine (vitamin B1), pyridoxine (vitamin B6), pantothenic acid and biotin, vitamin B12, folic acid, niacin (vitamin B3), vitamin A, or other deficiencies.

Additional tests may be done to rule out other possible causes of neuropathy. Tests may include:

• Serum chemistries
• Nerve conduction tests
• EMG
• Nerve biopsy
• Upper GI and small bowel series
• EGD (esophagogastroduodenoscopy)
• Isotope studies
• Voiding cystourethrogram