Case of the Month #18: Peripheral Neuropathy by Dr Lorraine de Gray

Published: 29/07/2022


Check the list below to see if you have covered most of the questions below:

It would be good to know if Mr X reports any of the following:

  • Subjective loss of power in his upper or lower limbs
  • Radicular arm or leg pain
  • Claudicant leg pain
  • Pins and needles affecting anywhere else in the body
  • Any issues with temperature sensation
  • Poor balance
  • Issues with micturition, including urgency, frequency, polyuria, recurrent infections
  • Food fads, poor diet
  • Heavy alcohol intake
  • Past history of cancer, in particular whether he has ever had chemotherapy
  • History of diabetes
  • Past history of known Vitamin deficiencies
  • Medication history
  • History of underactive thyroid
  • History of night sweats
  • History of enlarged lymph glands
  • History of serious infections
  • Occupation history in particular exposure to any toxins or heavy metals

Mr X reported that he had no issue with radicular, claudicant leg pain. or poor balance.  He reported occasional hesitancy of micturition, but no other symptoms.  He did report having night sweats, but no enlarged glands as far as he was aware.  He drunk less than two units of alcohol per week, and as far as he was aware had never had any issues with his thyroid.  He reported no other significant history in particular no history of cancer or serious infections.  He had not had COVID-19 infection as far as he knew.  He had no weight loss and apart from the multivitamins mentioned previously, as well as the Amitriptyline he was on no other medication.  He ate a well-balanced healthy diet and had worked in insurance in an office-based job for most of his working life.  When asked if he had had any blood tests in the recent past, he reported that he had not had any blood tests in the past two years.

You next go on to examine Mr X – what would you like to check for?