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Evaluation and Management of the Dysesthetic Patient

      Abstract

      Dysesthesia is symptomatology that includes, but is not limited to, sensations of pain, burning, crawling, biting, numbness, piercing, pulling, cold, shock-like, pulling, wetness, and heat. These sensations can cause significant emotional distress and functional impairment in affected individuals. While some cases of dysesthesias are secondary to organic etiologies, most cases exist without an identifiable infectious, inflammatory, autoimmune, metabolic, or neoplastic process. Ongoing vigilance is required for concurrent or evolving processes, including paraneoplastic presentations. Elusive etiologies, unclear treatment regimens, and stigmata leave patients and clinicians with a difficult path forward marked by “doctor shopping,” lack of treatment, and significant psychosocial distress. We addresses this symptomatology and the psychosocial burden that often comes with it. Although notoriously labeled as "difficult to treat," dysesthesia patients can be effectively managed, making life-changing relief possible for patients.

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