Mr Milton Fong
67 yr old Retired accountant
10 yr hx of type II diabetes. claim to be well controlled.
gradual onset of decreased sensitivity of feet over last 3 yrs and numbness.
also has unpleasant burning sensation in feet and toes - keeps him wake at night.
difficulty walking on uneven ground - especially in dark.
no family hx of similar symptoms.
Normal CN examination - but mild to moderate retinopathy.
- UL = normal tone, power, reflexes, sensation and coordination.
- Symmetrical decreased sensitivity - pin prick up to midshin level with diminished proprioception and vibration.
Absent ankle tendon reflexes.
Power relatively normal.

poor to moderate values of diabetic control.
microalbuminuria,
serum protein = normal.
syphillis, Hep B, C, and HIV = negative.
CSF protein non elevated.
nerve conduction studies = LL low amplitude or absent sensory responses compare to UL which is normal. EMG mildly lon duration high amplitude polyphasic motor unit potentials in distal but not proximal LL muscles.


TASKS:

1. Pathophysiology of Peripheral Neuropathy yazid

2. Clinical features of peripheral neuropathy vs myopathy - features of history maz

3. Diabetic foot care + how to manage pain and maintenence of function of neuropathy saree

4. investigations to diagnose peripheral neuropathy - nerve conduction studies! and others if there are. alvin

5. common causes of peripheral neuropathy & how it causes the peripheral neuropathy if there is an explanation how to classify them. chris

6. examination - Clinical features of peripheral neuropathy vs myopathy christine

5.