Area of impairment | Subjective symptoms | Objective signs | ||
---|---|---|---|---|
Symptom | Assessments (questionnaire) | Signs | Assessments | |
Somatic neuropathy | Pain, paresthesia | VAS (0–10) | Sensory loss for pain in LLs and ULs | Extension of sensory loss in LLs and ULs |
Extension on the body | NCS | |||
Skin punch biopsy | ||||
Walking difficulties | Walking perimeter | Walking difficulties | 10MWT | |
PND score (0–IV) | Timed Get Up and Go test | |||
NIS (0–192) | ||||
Balance disorders | Falls | Balance disorders | Romberg sign | |
Apallesthesia in the feet | ||||
Disability, difficulties with fine gestures | R-ODS (48–0) | Weakness in all 4 limbs | NIS | |
Grip test | ||||
Autonomic neuropathy | Faintness, syncope | Questionnaire | Cardiovascular dysautonomia | HRV test |
MIBG cardiac scintigraphy | ||||
Atropine IV test | ||||
Orthostatic hypotension | Serial supine and orthostatic BP and pulse | |||
Diarrhea, constipation, alternating diarrhea–constipation, early satiety, vomiting | Early satiety | Weight | ||
mBMI | ||||
Gastroparesis | Gastric emptying test | |||
Sweating abnormalities | Sweating abnormalities | Sudoscan® | ||
Urinary retention, incontinence, sexual dysfunction | Questionnaire | Â | Urodynamic assessment | |
Overall autonomic symptoms | COMPASS-31 (0–100) |  |  | |
CADT (20–0) | ||||
Amyloid cardiomyopathy | Excessive exertional tachycardia/syncope/bradycardia/palpitations (or none in early disease) | Questionnaire | Cardiac arrhythmia/atrial fibrillation | ECG |
Conduction disorders | 24-h Holter ECG | |||
 | EPS | |||
Shortness of breath, fatigue, weight gain, fluid retention in lower extremities, abdominal swelling | Questionnaire | Heart failure | Clinical examination including auscultation of heart and lungs | |
NYHA class | Volume overload/jugular venous distension/gallop rhythm/crackles (crepitant rales)/lower extremity edema | Body weight increase | ||
6MWT | ||||
NT-proBNP | ||||
Troponin | ||||
Cardiac imaging | Echocardiogram | |||
 | cMRI | |||
 | DPD/PYP scintigraphy | |||
Ocular manifestations | Ocular symptoms (blurred vision) | Questionnaire | Ocular dysautonomia | ACVs |
 | KCS | |||
 | Pupillary abnormalities | |||
Amyloid deposition | Glaucoma (tonometry) | |||
 | Vitreous opacities (slit lamp examination) | |||
Renal dysfunction | Fatigue, decreased urine output | Questionnaire | Renal dysfunction | eGFR |
 | Albuminuria | |||
 | Urine proteinuria | |||
General health | Fatigue | Questionnaire | Â | Â |
Cachexia | Body weight decrease | General health | mBMI | |
Quality of life | Norfolk QOL-DN questionnaire (− 4 to 136) |  | BMI | |
 | Prealbumin | |||
SF-36 questionnaire (0–100 per scale) |  |  | ||
KCCQa (100–0) |  |  |