{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T08:45:19Z","timestamp":1789202719205,"version":"build-2803163510"},"reference-count":70,"publisher":"IMR Press","issue":"4","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Neurol."],"abstract":"<jats:p>The purpose of this narrative review is to provide a clinic-ready synthesis of contemporary concepts in peripheral neuropathy, spanning epidemiology, diagnosis, and treatment, with emphasis on high-yield advances applicable to daily practice. The authors integrate pragmatic tools\u2014including a diagnostic algorithm, suggested initial laboratory panels, and commonly used outcome measures\u2014to support clinical decision-making. However, this review is intended as a clinic-oriented synthesis rather than a formal practice guideline. Peripheral neuropathy can be systematically categorized into seven pathophysiologic phenotypes\u2014(1) distal \u201cdying-back\u201d axonopathy, (2) neuronopathy (ganglionopathy), (3) demyelinating neuropathies, (4) small-fiber neuropathy, (5) autonomic neuropathy, (6) ischemic\/infiltrative\/inflammatory axonopathies, and (7) focal compressive\/entrapment neuropathies. An organized evaluation and management around this phenotype-first structure, combined with a structured stepwise escalation algorithm (from bedside pattern recognition to targeted laboratory testing, electrodiagnostics, selective imaging, small-fiber assessment, and immune work-up when indicated), bridges fragmented evidence into a clinic-ready decision-support framework that improves diagnostic precision, rational test utilization, and therapeutic alignment. Beyond optimizing pharmacologic care, neuromodulation may expand options in carefully selected patients. For painful diabetic peripheral neuropathy (DPN), high\u2011frequency (10 kHz) spinal cord stimulation (SCS) has been evaluated in randomized comparative studies against optimized medical management and has been associated with sustained pain reduction and functional improvement through 24 months in follow\u2011up reports, supporting consideration in medication\u2011refractory cases where access and patient factors permit. Ultrasound \u2011guided pulsed radiofrequency (PRF)\u2014a nondestructive, field\u2011based neuromodulation that limits tip temperature to &lt;42 \u00b0C\u2014has been studied in small randomized trials and observational cohorts for focal entrapment\u2011type neuropathic pain after positive diagnostic blocks; reported benefits are generally short\u2011 to mid\u2011term with heterogeneous protocols, so certainty varies by indication. For hereditary transthyretin amyloid polyneuropathy (ATTRv), disease\u2011modifying approaches\u2014including nucleic acid\u2013based therapies\u2014are increasingly integrated into contemporary care. Overall, these developments support earlier pattern recognition, more precise phenotyping, and rational escalation while using standardized outcome measures to track response.<\/jats:p>","DOI":"10.31083\/rn48384","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:48:35Z","timestamp":1777448915000},"source":"Crossref","is-referenced-by-count":3,"title":["Peripheral Neuropathy: A Phenotype-Driven Review for Diagnosis and Management"],"prefix":"10.31083","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8090-6047","authenticated-orcid":true,"given":"Tomoo","family":"Yuba","sequence":"first","affiliation":[{"name":"Assistant Professor, Department of Anesthesiology and Intensive Care, Osaka University Hospital, 565-0871 Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4344-8131","authenticated-orcid":true,"given":"Ali","family":"Dabbagh","sequence":"additional","affiliation":[{"name":"MD, Professor, Anesthesiology Research Center, Department of Anesthesiology, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, 4739 Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2348-5138","authenticated-orcid":true,"given":"A. Sassan","family":"Sabouri","sequence":"additional","affiliation":[{"name":"Assistant Professor of Anesthesiology, Harvard Medical School, Boston, MA 02115, USA"},{"name":"Anesthesiologist, Department of Anesthesiology, Mass General Brigham, Boston, MA 02114, USA"},{"name":"Visiting Professor, Department of Anesthesiology, Shahid Beheshti Medical Science University, 4739 Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Mirian A, Aljohani Z, Grushka D, Florendo-Cumbermack A. Diagnosis and management of patients with polyneuropathy. CMAJ: Canadian Medical Association Journal = Journal De L\u2019Association Medicale Canadienne. 2023; 195: E227\u2013E233.","DOI":"10.1503\/cmaj.220936"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Siao P, Kaku M. A Clinician\u2019s Approach to Peripheral Neuropathy. 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