Which symptom suggests autonomic neuropathy rather than peripheral neuropathy?

• A. Erectile dysfunction
• B. Reduced sensation in feet
• C. Numbness in toes
• D. Tingling in hands

Answer: (A)

Autonomic neuropathy affects autonomic nerves that regulate involuntary functions, including sexual arousal and erection. Erectile function depends on autonomic control of blood flow and smooth muscle in the penis, so impairment of these autonomic pathways can lead to erectile dysfunction even when sensation is intact. The other symptoms—reduced sensation in the feet, numbness in the toes, and tingling in the hands—reflect damage to somatic (sensory) peripheral nerves, which is characteristic of peripheral neuropathy rather than autonomic dysfunction. Thus erectile dysfunction points to autonomic involvement, whereas the others represent sensory peripheral nerve issues.