--refers to the tendency, especially in vasculitic/metabolic neuropathies (which have numerous etiologies) for nerves to "die-back", starting at the nerve tips farthest away from the center of the body (and the center of circulation) and progressing (usually slowly) towards the center. In such cases, symptoms are noticed in the toes first, then feet and maybe fingertips, then calves and hands, leading to what is called the "stocking and glove" distribution.

The mechanism of the neuropathy in such cases is primarily ischemic. Whatever the etiology, it results in cirucltory insufficiency, and this is most pronounced the farther away from the heart one gets. When circulation is compromised, the nerves farthest from the center have the most trouble getting nutrients and oxygen, and removing metabolic toxins, so they experience dysfunction first.

This is also why circulatory helpers--from exercise to blood thinners--may help symptoms and slow/halt progresssion.

Problem is, symptoms in extremities can be caused by a lot of other things--peripheral artery disease, spinal compression on certain nerve roots, localized bony spurs, or compromise at natural nerve "choke points", as in carpal or tarsal tunnel syndromes.

NON length dependent syndromes usually result in symptoms in many parts of the body, not just those farthest from the heart, and, especially if they come on fast, imply an autoimmune or toxic etiology.

And hereditary neuropathy syndromes are a real wild card--some progress slowly or not at all, some quickly, some involve die-back, some are more global, and often the same syndrome will affect different people in different ways.