Peripheral neuropathy is usually:

• A. unilateral and symmetric
• B. unilateral and asymmetric
• C. bilateral and symmetric
• D. bilateral and asymmetric

Answer: (C)

Peripheral neuropathy from systemic or metabolic causes tends to affect many nerves in both limbs in a similar way, especially starting in the distal parts. This bilateral, symmetric pattern is typical because the pathogenic process impacts peripheral nerves diffusely, with the longest nerves affected first, so you often see distal symptoms in both feet (and hands) that may progress upward.

That’s why the best description is bilateral and symmetric. Unilateral involvement points to a localized nerve problem rather than a diffuse polyneuropathy, and bilateral asymmetric would mean both sides are involved but not equally, which is less typical for generalized neuropathy.