Diagnosing peripheral neuropathy in South‐East Asia: A focus on diabetic neuropathy
Rayaz A. Malik, Aimee Andag‐Silva, Charungthai Dejthevaporn, Manfaluthy Hakim, Jasmine Shimin Koh, Rizaldy Taslim Pinzon, Norlela Sukor, Ka Sing Wong
Abstract
Abstract Burning and stabbing pain in the feet and lower limbs can have a significant impact on the activities of daily living, including walking, climbing stairs and sleeping. Peripheral neuropathy in particular is often misdiagnosed or underdiagnosed because of a lack of awareness amongst both patients and physicians. Furthermore, crude screening tools, such as the 10‐g monofilament, only detect advanced neuropathy and a normal test will lead to false reassurance of those with small fiber mediated painful neuropathy. The underestimation of peripheral neuropathy is highly prevalent in the South‐East Asia region due to a lack of consensus guidance on routine screening and diagnostic pathways. Although neuropathy as a result of diabetes is the most common cause in the region, other causes due to infections (human immunodeficiency virus, hepatitis B or C virus), chronic inflammatory demyelinating polyneuropathy, drug‐induced neuropathy (cancer chemotherapy, antiretrovirals and antituberculous drugs) and vitamin deficiencies (vitamin B 1 , B 6 , B 12 , D) should be actively excluded.