"Burning feet" as the only manifestation of dominantly inherited sensory neuropathy.

A young woman had chronic symptoms of "burning feet" but no clinical or neurophysiologic findings of neuropathy. These symptoms were aggravated by warmth and ameliorated by cooling. Extensive pathologic grading of teased sural nerve fibers, however, provided suggestive evidence of a low-grade pathologic abnormality. Other kin were discovered to have similar symptoms in an autosomal-dominant pattern, and some of these relatives had evidence of a subclinical sensory neuropathy. From this experience, we infer that a mild subclinical neuropathy may underlie the symptom of burning feet; burning pain of the feet may be dominantly inherited; hereditary sensory neuropathy may, therefore, manifest with only positive symptoms of burning pain, restless legs, and lancinating pain, rather than with mutilating acropathy, neurotrophic arthropathy, or severe distal sensory loss as is usually reported; and temperature may modulate physiologic mechanisms related to the experience of burning pain.