| CONSULT REQUEST GUIDELINES
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Peripheral Neuropathy
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| Suggested Pre-Referral Evaluation and Management Guidelines |
Consider the following possibilities:
- Diabetes
- Consider alcohol induced, nutritional, hormonal, toxic and possible inflammatory
- Central mechanisms
Treatment: anticonvulsants, TCA's.
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| Suggested Additional Test/Management Prior to Specialty Visit |
TSH, T4, SPEP, B12, WESR, CBC, AST/ALT, creatinine, OGTT (Oral Glucose Tolerance Test), Alc. Consider EMG if motor involvement. Consider HIV based on risk factors.
Please include any relevant history, imaging studies or EMG
Refer to U of M Back & Pain Center.
For more information regarding our program and what we offer please visit our website at U of M Back & Pain Center (www.umpain.com)
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| Patient Education/Information (includes preps) |
Counsel about using nightlight at night, careful foot care.
Department of Neurology Guidelines |
| Appointment Timeframe |
Next available appointment (2-4 weeks)
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| How to Get Results to Consultant |
UMHS Patients: See MiChart
External Patients: Hand carry non-UM records to visit or fax to 734-936-6585 |
| Clinic Contact Information |
Physicians: 800-962-3555
Patient: 734-615-7246 |
| Clinic Location Sites |
Brighton Health Center
Burlington Building
Canton Health Center
Dexter
East Ann Arbor
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| UM Consulting Physician |
U of M Back & Pain Center Faculty
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| Revised on: |
10/01/2012 |
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