Distal polyneuropath: Skin biopsy is useful for detection of peripheral neuropathy predominantly affecting small unmyelinated nerve fibers, likley ruled out in your case. Depending on the clinical presentation, nerve & possibly muscle biopsy are needed. Emg/ncv, MRI (cns/spine), labs including blood and CSF serologic studies, & consultation w/ neuro & int med/rheum.
Answered 2/2/2017
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