| Direct mechanical compression | Amyloid deposits compress nerve fibers within the endoneurium and perineurium |
| Ischemic injury | Amyloid infiltration of the vasa nervorum compromises the blood supply to peripheral nerves |
| Toxic oligomer effects | Pre-fibrillar TTR oligomers may directly damage neuronal membranes and induce oxidative-stress |
| Schwann cell dysfunction | Amyloid deposition disrupts Schwann cell integrity, leading to demyelination and impaired axonal support |
| Autonomic ganglion involvement | Amyloid deposits in sympathetic and parasympathetic ganglia cause autonomic dysfunction |
| Progressive motor weakness | Ascending weakness leading to gait difficulty, foot drop, and eventually wheelchair dependence |
| Neuropathic pain | Often severe, with burning, shooting, and lancinating qualities |
| Carpal tunnel syndrome | Bilateral carpal tunnel syndrome may precede systemic symptoms by years and represents an important diagnostic clue |
| Databases | OMIMOrphanetClinicalTrialsPubMed |
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