I was referred a patient today and their GP was insitent in the letter that they had diabetic neuropathy. (aged 72)
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The patient complained of burning during the night, occasional pins and needles, minor interuptions to balance and some discomfort in the gastrocs when walking up hills. (History revealed no cardiac complications).
However,
Monofilament, vibratory, and vascular testing all were within normal limits. Skin and hair growth on the feet appeared very good for a man of 72.
The patient also underwent major abdominal/ spine surgery some 30 years ago. And a bilateral knee replacement 2 years ago , which is around the time the neuropathic symptoms appeared.
I have never seen a patient who complains of all the symptoms, yet, illicits results within the normal range.
Has anyone any thoughts on this enigma ??
Thanks in advance
FDCB
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