You haven’t lived until you’ve seen a patient from Mashkay walk into your OPD with numb feet, burning soles, and a Vitamin B12 level lower than your phone battery on call duty. Peripheral neuropathy is a common clinical finding with many possible culprits, but thankfully, we’ve got a trusty mnemonic that keeps our neurons — and our memory — firing: “ABCDE.”
Mnemonic: “A.B.C.D.E” — Causes of Peripheral Neuropathy 🧠
| Letter | Cause | Explanation |
|---|---|---|
| A | Alcohol | Chronic use = direct neurotoxicity + nutritional deficiency (esp. thiamine). 🍷 |
| B | B12 Deficiency | Think vegan diet, pernicious anemia, metformin overuse. |
| C | Chronic Renal Failure & Carcinoma | Uremic toxins or paraneoplastic syndromes. |
| D | Diabetes & Drugs | Most common cause. Drugs? INH, amiodarone, chemo agents, nitrofurantoin. 💊 |
| E | Every Vasculitis | PAN, SLE, RA — immune-mediated nerve damage. |
🩺 Clinical Experience from the Wards
Last winter, we had a 58-year-old retired schoolteacher from Kharan, presenting with burning feet and reduced pinprick sensation up to mid-calf — your classic glove-and-stocking distribution.
Dr. Basit Khan ordered a B12, fasting glucose, renal profile — and boom 💥 — B12 was 120 pg/mL, HbA1c 8.9%, and GFR was flirting with 40. A neuropathy triple whammy. We blamed the B12, treated the diabetes, and gave him a new reason to stop drinking chai on an empty stomach — methylcobalamin injections instead. 😉
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