Amyloid neuropathy generally starts by affecting physical sensation, causing numbness and pain which initially affect the feet. This progressively spreads to the other limbs: first to the hands and then the rest of the upper limbs. This can develop into mobility problems, starting in the feet, and progressing in the same way as the numbness and pain, which can cause the hands and feet to function differently. The speed and degree to which nerve damage occurs varies depending on the type of amyloidosis. It also differs from patient to patient.

Diagnosis is made through clinical examination and electromyogram. If the ‘vegetative’ nerves are damaged, this often causes sensory and motor problems. The ‘vegetative’ nerves control the body’s autonomic functions (digestion, sexual function, urinary processes, sustaining blood pressure when standing).

Symptoms indicating autonomic damage are: Dizziness when standing up (orthostatic hypotension) which can cause fainting, early satiety, nausea, vomiting, stubborn constipation or diarrhoea which can sometimes be explosive after eating, or even an alternation between these two sorts of bowel problems. Patients might also experience problems with their genitalia and urination. These problems often start prematurely in men.

Having carpal tunnel syndrome is also common amongst those who have amyloidosis. This results in pains, pins and needles and electric shock sensations in the palm side of the first three fingers of each hand. These symptoms are at their most noticeable during the night. Motor dysfunction can occur if there is no surgical intervention. The multitude of symptoms can confuse matters and patients can undergo many tests without obtaining a diagnosis.

Diagram of the organs which can be affected by dysautonomia