A diagnostic challenge in peripheral neuropathy

摘要

I attended a tutorial on peripheral neuropathy in March 1969. The patient was a 45-year-old married mother of two primary school children. She had been unwell since the beginning of the year and had been admitted for investigation to the Warneford Hospital, Leamington Spa. The tutorial was conducted by a neurologist, for the benefit of four medical registrars about to sit the MRCP exam. The main focus was not on the patient's history or diagnosis, but rather on the conduct of the neurological exam. Each of the registrars demonstrated a part of the examination. My task was to examine the patient's legs. I recall commenting on the dry scaly skin. Our tutor murmured that this was hardly worthy of a referral to a dermatologist. He further informed us that, as was often the case with peripheral neuropathies, no cause had been found.