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Peripheral neuropathy may first be considered when an individual reports symptoms of numbness, tingling, and pain in feet. After ruling out a lesion in the central nervous system as a cause, a diagnosis may be made on the basis of symptoms, laboratory and additional testing, clinical history, and a detailed examination.
Signs and symptoms of proximal diabetic neuropathy depend on the nerves affected. The first symptom is usually pain in the buttocks, hips, thighs or legs. This pain often starts suddenly and affects one side of the body, although may spread to both sides.
Diabetic neuropathy can affect any peripheral nerves including sensory neurons, motor neurons, and the autonomic nervous system. Therefore, diabetic neuropathy has the potential to affect essentially any organ system and can cause a range of symptoms. There are several distinct syndromes based on the organ systems affected. [citation needed]
Typical early symptoms are "tingling" (sort of electrified vibration or paresthesia) or numbness in the extremities, frequent (night) leg cramps, loss of reflexes (in knees), muscle fasciculations, "vibration" feelings, loss of balance, general muscle cramping and nerve pain.
The signs and symptoms of Peripheral mononeuropathy and neuropathy vary as a result of the types of individual and/or nerve areas affected. There are three types of nerve damage, including: "motor nerve damage, sensory nerve damage, and autonomic nerve damage". [2]
The combination of increased pain signaling and degeneration of pain-transmitting fibers leads to a variable condition with signs and symptoms that can change over time. SCN9A gene mutations have been found in approximately 30 percent of individuals with small fiber neuropathy; SCN10A gene mutations are responsible for about 5 percent of cases.