Which statement best describes the typical pattern of chemotherapy-induced peripheral neuropathy?

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

Answer: (A)

Chemotherapy-induced peripheral neuropathy most often shows a length-dependent, systemic pattern. The typical presentation is symmetric involvement of both sides, starting in the distal feet and hands and then possibly spreading proximally—the classic stocking-glove distribution. This bilateral, symmetric involvement occurs because the circulating neurotoxic drug affects nerves throughout the body, with the longest nerves (in the feet and hands) becoming symptomatic first. If symptoms were unilateral or highly asymmetric, other causes like a localized nerve injury or radiculopathy would be more likely. So the hallmark pattern is bilateral and symmetric sensory changes beginning in the distal extremities.