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Peripheral neuropathy (sensory neuropathy)

A Canadian clinical summary of peripheral neuropathy (sensory neuropathy), with source-attributed priorities and explicit jurisdiction boundaries.

JurisdictionCanada
Source check2026-08-20
Clinical reviewiatroX editorial team 路 Clinical editorial review 路 reviewed 2026-08-20 路 due 2027-08-20
AudienceHealthcare professionals practising in Canada
This is an iatroX educational summary of named Canada sources, not an official guideline. It does not replace the complete source documents, local policy, specialist advice or clinical judgement. The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.

Source and scope

This summary is bounded to the recommendations, population and decisions covered by Diagnosis and management of patients with polyneuropathy. Apply it with the current provincial or territorial pathway where implementation differs.
sources for this section:CMAJ polyneuropathy

Source-attributed clinical priorities

  • Define the tempo and distribution, confirm objective sensory or motor findings and identify urgent asymmetric or rapidly progressive patterns.
  • Investigate common treatable causes through history, examination and targeted laboratory testing rather than broad untargeted panels.
  • Treat the cause where possible, protect insensate feet and use neuropathic-pain treatment only when painful symptoms warrant it.
  • Tempo and pattern determine urgency: a chronic symmetric sensory neuropathy differs from an acute multifocal motor process.
sources for this section:CMAJ polyneuropathy

Practical assessment and management workflow

1
Document sensory, motor, autonomic and pain symptoms and exposure to diabetes, alcohol, chemotherapy and nutritional risk.
2
Examine reflexes, strength, gait, vibration, pin sensation and feet and identify asymmetry or a sensory level.
3
Order focused glucose, blood count, renal, liver, thyroid, B12 and paraprotein testing as clinically indicated.
4
Treat the cause, institute foot protection and arrange neurology or electrodiagnostic review for atypical disease.
sources for this section:CMAJ polyneuropathy

Safety, red flags and urgent escalation

  • Ascending weakness, bulbar symptoms, respiratory difficulty or severe autonomic instability requires emergency assessment.
  • Urgently investigate a rapidly progressive, asymmetric or predominantly motor neuropathy.
  • Do not use neuropathic-pain medicine for numbness alone when it adds sedation without a symptomatic target.
sources for this section:CMAJ polyneuropathy

Confirm the local pathway before acting

The evidence source is pan-Canadian, but formularies, funded access, referral routes, public-health directions and service availability remain provincial or territorial.
sources for this section:CMAJ polyneuropathy

Source and implementation boundary

Read this educational summary with the linked source, current Canadian product information where medicines are involved, and the applicable provincial or territorial pathway. Local formularies, reporting duties, referral routes and service availability can differ.
sources for this section:CMAJ polyneuropathy

Source documents

Use the linked source documents for complete recommendations, evidence grading, exclusions and implementation detail.

  1. Canadian Medical Association JournalDiagnosis and management of patients with polyneuropathyCMAJ 2023;195:E227-E233; DOI 10.1503/cmaj.220936 路 accessed 2026-08-20
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