Certified Neuroscience Registered Nurse (CNRN) Practice Exam

What condition is characterized by a symmetric, bilateral distribution of sensory and motor deficits, beginning distally and progressing proximally?

1. Multiple sclerosis

2. Diabetic peripheral neuropathy

3. Cerebral palsy

4. Stroke

The correct answer is: Diabetic peripheral neuropathy

The condition characterized by a symmetric, bilateral distribution of sensory and motor deficits that begins distally and progresses proximally is diabetic peripheral neuropathy. This condition commonly arises in individuals with diabetes, resulting from prolonged elevated blood sugar levels that can damage peripheral nerves. In diabetic peripheral neuropathy, patients often experience symptoms that start in the lower extremities, such as tingling, burning, or numbness in the toes and feet. As the condition advances, these symptoms can spread up the legs, and similar deficits may eventually occur in the hands. The symmetric distribution is typical of polyneuropathies, where both sides of the body are affected similarly. This pattern stands out distinctly in contrast to other conditions like stroke or cerebral palsy, which typically present with unilateral symptoms or motor deficits concentrated on one side of the body. Additionally, while multiple sclerosis involves nerve damage and can lead to various sensory and motor deficits, its progression and patterns of symptoms can be more varied, often including attacks and remissions that don’t follow the same distal-to-proximal pattern seen with diabetic peripheral neuropathy.