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Clinical Crossroads Update
January 4, 2012

Update: A 52-Year-Old Woman With Disabling Peripheral Neuropathy

JAMA. 2012;307(1):85. doi:10.1001/jama.2011.1951

In a Clinical Crossroads article published in October 2009,1 Seward B. Rutkove, MD, discussed peripheral neuropathy, reviewing its epidemiology, the issue of screening, and the treatment options available. The patient, Ms Q, was a 52-year-old registered nurse with diabetes who had experienced neuropathic symptoms including cramping, burning, and numbness in both lower extremities for 8 years. Ms Q had tried multiple medications without improvement. She found that topiramate and gabapentin were ineffective. At the time of the conference, Ms Q used lidocaine patches; duloxetine, 60 mg/d; oxycodone/acetaminophen, 5 mg/325 mg as needed; and arnica cream.