acute

Sensation Disturbances

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 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 against2 documents

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 date2026-08

Presentation reference

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

SourceStatPearls "Sensory Neuropathy" - disease-level clinical article

Presentation findings are traced to the source above.

GABAPENTIN

1st line

Formoral.solid

Adult dose and duration

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.

Paediatric dose

The formulary's paediatric gabapentin dosing is for epilepsy with partial-onset seizures, not for pain, and is not reproduced here.

Dose 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.

Cautions

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.

Egyptian brands

Egyptian brand	Manufacturer	Indicative price
GABA 100MG 10 CAPS.	MULTI-APEX > MULTIPHARMA	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 PHARMACEUTICALS	156.00 EGP
STABLENTIN 6MG/120ML SYRUP? strength differs? different route - not oral solid	MEPACO	21.60 EGP
ADAPTAN 250MG/5ML ORAL SOLUTION 100 ML? strength differs? different route - not oral solid	EUROPEAN EGYPTIAN PHARM. IND.	37.00 EGP

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.