Peripheral Neuropathy Plan

[textarea default="evaluation:
- complete blood count, comprehensive metabolic profile,  erythrocyte sedimentation rate, fasting blood glucose, vitamin B12, and thyroid-stimulating hormone level (level C evidence)
- electrodiagnostic studies if symptoms persist and if the diagnosis remains unclear after initial diagnostic testing and a careful history and physical examination (level C evidence)
symptomatic treatment:
- antiseizure medications
gabapentin [Neurontin]:  300 mg by mouth day 1, twice daily on day 2, then three times daily with max dose 3600 mg
topiramate [Topamax]:  consider migraine prophylaxis dose 25 mg every night at bedtime for 1 week, then increase by 25 mg per week with max dose 200 mg
carbamazepine [Tegretol]: 100 mg twice daily increase 200 mg/day divided twice daily with max dose 1200 mg
pregabalin [Lyrica]:  start 50 mg three times daily, increase to 300 mg/day divided 3 times daily over 7 days with max dose 300 mg
- tricyclic antidepressants
amitriptyline [Elavil]: start 0.1 mg/kg every night at bedtime, titrate slowly over 2-3 weeks with a max dose of 150 mg
- topical medications
lidocaine [Lidoderm]: 12 hours daily
capsaicin [Zostrix]:  may apply twice daily to three times daily"]