[The diagnosis of acquired sensory neuropathies]

Peripheral neuropathies usually include a sensory component of various causes. The diagnosis approach requires careful a clinical assessment and a precise electrophysiological exploration.

Axonal sensory polyneuropathies are classified according to the type of fibers involved (large or small fibers). While there is a large number of causes, current emphasis is placed on glucose intolerance as a source of small-fiber sensory neuropathies. Demyelinating polyneuropathies are often associated with a monoclonal IgM gammapathy with anti-MAG activity. Multiple sensory mononeuropathies are exceptional and suggest possible early-phase vasculities, sensorymotor neuropathy with conduction blocks or leprosy. Sensory neuronopathies can also suggest Sjögren's syndrome or a paraneoplastic syndrome. Finally chronic sensory polyradiculoneuritis constitute a rare subgroup clearly defined as demyelinating inflammatory neuropathy.

The diagnostic approach to sensory neuropathies requires careful nosological electroclinical classification to reduce the number of explorations performed for etiological diagnosis.