However, it is important to recognize and distinguish autonomic neuropathy from diseases of the end-organs themselves. Symptoms may be non-specific making the diagnosis of autonomic neuropathy more difficult to identify. Autonomic neuropathy may affect a variety of organ systems such as the cardiovascular, gastrointestinal, and genitourinary systems. Carpal tunnel symptoms may include pain and sensory disturbances in the lateral palm and fingers hand weakness may ensue if the focal neuropathy is severe. The most common focal neuropathy is a median neuropathy at the wrist, or clinically known as carpal tunnel syndrome. Symptoms begin in the feet and ultimately progress to the proximal legs and hands. One of the most common phenotypes is sensorimotor polyneuropathy, which is characterized by symptoms of neuropathic pain, numbness, and in advanced cases weakness. The presenting symptoms depend on the distribution of nerves affected. This may lead to focal, multifocal, or diffuse neuropathies involving sensory, motor and/or autonomic fibers. Although the cause of neuropathy is not entirely clear, it is likely related to amyloid deposition within the nerve. Peripheral neuropathy is a common complication of many of the systemic amyloidoses.
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