Prevalence and Electrophysiological Patterns of Peripheral Neuropathy in Cirrhosis: An Etiology-Specific Cross-Sectional Study

Background: Peripheral neuropathy (PN) is a significant yet under-recognized neurological complication of chronic liver disease (CLD). Understanding its pattern across etiologies and severity strata can guide earlier recognition and management. Material and Methods: A cross-sectional study was conducted at a tertiary-care teaching hospital. A total of 120 consecutive adult patients with confirmed cirrhosis were evaluated clinically; nerve conduction studies (NCS) were performed to confirm and classify PN. Disease severity was categorized by Child-Pugh criteria, and between-group differences were analyzed using appropriate statistical tests. Results: We included 120 participants (male 88, 73.3%; female 32, 26.7%). The overall prevalence of PN was 60.8% (73). The predominant phenotype was pure sensory (27, 37.0%), followed by mixed sensorimotor (20, 27.4%) and pure motor (17, 23.3%). Prevalence increased significantly with Child-Pugh severity: Class A (3, 15.0%), Class B (45, 67.2%), and Class C (25, 75.8%) (P<0.001). Across etiologies, PN was highest in Hepatitis B (19, 65.5%), followed by cryptogenic (8, 61.5%) and alcoholic cirrhosis (44, 59.5%) (P=0.028). Purely axonal degeneration was the predominant electrophysiological pattern (95.9%). Conclusion: PN is highly prevalent in cirrhosis, manifesting primarily as an axonal sensory neuropathy. Its frequency increases significantly with hepatic decompensation and varies by viral and metabolic etiologies. Findings support routine electrophysiological screening in cirrhotic patients.

Keywords: Peripheral neuropathy; Cirrhosis; Nerve conduction studies; Child-Pugh score; Axonal degeneration.