# Sensation Disturbances - Category: acute - Review status: reviewed (every claim checked against a document named on this page) - Sources: Egyptian National Drug Formulary - nervous-2025.pdf, Gabapentin monograph (chapter PDF p68) · Egyptian National Drug Formulary 2025 — Nervous System Disorders, Gabapentin monograph, Peripheral Neuropathic Pain in adults (nervous-2025.pdf, page index 67, printed p57) · Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. - Verified date: 2026-08 ## Verified against - Egyptian National Drug Formulary 2025 — Nervous System Disorders, Gabapentin monograph, Peripheral Neuropathic Pain in adults (nervous-2025.pdf, page index 67, printed p57) - Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. ## Treatment metadata - Gabapentin — oral.solid ## Complete treatment card ```text SENSATION DISTURBANCES Sources: Egyptian National Drug Formulary - nervous-2025.pdf, Gabapentin monograph (chapter PDF p68) · Egyptian National Drug Formulary 2025 — Nervous System Disorders, Gabapentin monograph, Peripheral Neuropathic Pain in adults (nervous-2025.pdf, page index 67, printed p57) · Bodman MA, Dreyer MA, Varacallo MA. Diabetic Peripheral Neuropathy. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2026 Jan-. Review status: REVIEWED against 2 sources listed above (2026-08) IS IT THIS? - reference only, to read alongside your own examination SYMPTOMS - what the patient reports (6) - Unsteadiness appearing early is among the most distinctive features, from damage to the nerves carrying signals inward [unsteadiness] - As it advances, the hands and feet writhe once the patient shuts their eyes - Pins and needles and electric shock sensations in the limbs, in a stocking-and-glove pattern, when small and medium fibres are hit [shock · tingling] - Numbness is the loss-type symptom; in the feet it is patchy rather than confined to the longest nerves [numbness] - In diabetes above all, look actively for those loss-type symptoms of small-fibre disease - How fast it progresses matters: immune and post-infectious cases move over weeks, while the unexplained ones barely change SIGNS - what you find (2) - Muscle weakness usually does not go with it [muscle weakness] - Where the cause is paraneoplastic, motor function can be involved and the stretch reflexes disappear TESTS (12) - Assessment rests on nerve physiology testing and on skin biopsy - In small-fibre disease the EMG can read entirely normal, and intact sural and plantar responses do not exclude it - On EMG the usual finding is a sensory nerve action potential that is reduced or gone - In diabetic sensory neuropathy the 5.07 monofilament is applied at several points on the foot to test the protective threshold of 10 g of force - Demyelination shows as conduction velocity below 75% of the normal lower limit, and distal latency beyond 130% of the normal upper limit - It can also shift amplitude through secondary loss of axons, and turns up in Guillain-Barre and in chronic inflammatory demyelinating polyneuropathy - Autonomic testing measures hot and cold sensation, brief shifts in skin electrical potential from sweat glands, and skin conductance for failed sweating - For small-fibre-dominant disease, the quantitative sudomotor axon reflex test and thermoregulatory sweat testing are the most useful, though few centres offer them - Skin biopsy is the validated reference test for small fibre neuropathy, sensitivity reaching 90% and specificity 97% - It is easy to perform and does little harm; the usual sites are the lower leg 10 cm above the outer ankle bone, and the outer thigh - Nerve biopsy is generally not needed to make the diagnosis - Imaging earns its place mainly for paraneoplastic causes; MRI, including inversion recovery and T2-weighted gradient-echo sequences, shows disease of the dorsal columns IF NOT THIS - what else fits (12) - Nerve damage from diabetes - Nerve damage from alcohol - Guillain-Barre syndrome - Charcot-Marie-Tooth disease - An autoimmune neuropathy - Nerve damage linked to HIV - Nutritional deficiency, vitamin B12 above all - Infection, for instance Lyme disease or leprosy - Toxins, for instance arsenic or lead poisoning - In a good share of patients no cause emerges; the unexplained form is a diagnosis of exclusion and may itself be autoimmune - Look-alikes: sensory CIDP, and distal acquired demyelinating symmetric neuropathy - It can also mimic nerve root disease, spinal cord disease and autoimmune disease Source StatPearls "Sensory Neuropathy" - disease-level clinical article Status traced to the source above 1. GABAPENTIN [1st line] Adult Peripheral neuropathic pain, immediate-release: Day 1, 300 mg orally once; Day 2, 300 mg twice daily; Day 3, 300 mg three times daily; then increase in 300 mg/day steps every 2-3 days as needed, up to 1800 mg/day in three divided doses. - As directed; the minimum time to reach 1800 mg/day is one week. Reassess response before increasing further or referring, and stop gradually over at least 1 week. Peds The formulary's paediatric gabapentin dosing is for epilepsy with partial-onset seizures, not for pain, and is not reproduced here. Source Egyptian National Drug Formulary 2025 — Nervous System Disorders, Gabapentin monograph, Peripheral Neuropathic Pain in adults (nervous-2025.pdf, page index 67, printed p57) Why Gabapentin is a standard symptomatic treatment for peripheral neuropathic sensory disturbance, most often due to diabetic neuropathy, while the underlying cause is investigated. Caution Discontinue gradually over a minimum of 1 week, whatever the indication. Reduce the dose in renal impairment: total daily dose 400 to 1400 mg divided twice daily at CrCl 30-59 mL/min, and 200 to 700 mg once daily at CrCl 15-29 mL/min. Do not leave more than 12 hours between doses; the total daily dose is divided into three. The formulary gives this dose for peripheral neuropathic pain in adults (painful diabetic neuropathy, post-herpetic neuralgia). Sedation and dizziness are common, especially at initiation - caution with driving or operating machinery. Reduce dose in renal impairment. Taper gradually if stopping, over a minimum of 1 week. Sudden dense numbness or weakness (possible stroke or acute cord compression), saddle numbness with new bladder/bowel dysfunction (possible cauda equina syndrome - emergency), or rapidly ascending numbness or weakness (possible Guillain-Barre syndrome) need urgent assessment, not gabapentin alone. Check blood glucose/HbA1c - diabetic peripheral neuropathy is the most common treatable cause. Egypt GABA 100MG 10 CAPS. MULTI-APEX > ... 6.50 EGP (0.65/unit) PENTALIPSY 100 MG 10 CAPS. SAFE PHARMA 8.00 EGP (0.80/unit) EZAPENTIN 300MG 10 CAPS. MULTI-APEX 11.00 EGP (1.10/unit) GABAPENTIN 300 MG 30 CAPS. UNIPHARMA 96.00 EGP (3.20/unit) ANDOPENTENE XR 300 MG 20 F.C. TABS. ANDALOUS PHARMA 90.00 EGP (4.50/unit) CONVENTIN 600 MG 30 TABS. EVA PHARMA 171.00 EGP (5.70/unit) GABAVERONA 400 MG 30 H.G. CAPS. AVERROES PHARMA 156.00 EGP SAJALIPSY 400 MG 30 H.G. CAPS. SAJA PHARMACE... 156.00 EGP STABLENTIN 6MG/120ML SYRUP MEPACO 21.60 EGP -> ? strength differs, ? different route - not oral solid ADAPTAN 250MG/5ML ORAL SOLUTION 100 ML EUROPEAN EGYPTIAN PHARM. IND. 37.00 EGP -> ? strength differs, ? different route - not oral solid Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy. ``` --- Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement. [Privacy policy](/privacy)