Even after extensive diagnostic evaluation, the cause of peripheral neuropathy remains uncertain in as many as 40% of patients who present to tertiary care referral centers. The management of these patients with so-called chronic idiopathic axonal polyneuropathy (CIAP), especially those with predominantly sensory symptoms and pain, is a difficult and frustrating clinical problem faced by neurologists.1 Patients usually find this nondiagnosis of idiopathic neuropathy difficult to accept, especially when they learn that treatment often involves only symptomatic pain management, a process that is often unsatisfactory.
Kissel JT. Peripheral Neuropathy With Impaired Glucose Tolerance: A Sweet Smell of Success? Arch Neurol. 2006;63(8):1055–1056. doi:10.1001/archneur.63.8.1055
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