--refers to the presentation of neuropathy that begins first in those nerve farthest from the center of the body--generally in the toes and tips of fingers.

It is the most common way that neuropathy begins, in keeping with endocrine (diabetic) and ischemic etiologies being the most common; generally, those nerves farthest from the center of circulation are the first to feel the effects of circulatory insufficiency, as oxygen/nutrients simply have a longer course to travel to get to them and waste products have a longer trip to be fully removed. In time, if the neuropathy progresses, there is "die back"--the neuropathy seems to move more towards the center of the body as nerves in the feet/legs and hands become involved.

Though this is the most common presentation, it is certainly not the only one. Other causes may result in other body parts being affected first, or various ones simultaneously, etc.