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15

Do you feel numbness?

Yes No

14

Do you experience tingling?

Yes No

13

Does the burning sensation bother you?

Yes No

12

Do you feel a "crawling" sensation in your hands or feet?

Yes No

11

Do you notice a decrease in sensitivity (for example, you got burned and don't feel it)?

Yes No

10

Do you have any nagging pains?

Yes No

9

Are there sharp shooting pains that feel like an electric shock?

Yes No

8

Do you feel muscle weakness?

Yes No

7

Do you notice paleness of the skin at the site of the lesion?

Yes No

6

Do you notice a feeling of coldness in your hand or foot?

Yes No

5

Do you experience difficulty bending or straightening your arms or legs?

Yes No

4

Are there difficulties with buttoning up or tying shoelaces?

Yes No

3

Do you have difficulty putting on clothes or moving objects?

Yes No

2

Are there any muscle twitches in any area?

Yes No

1

Do you notice any trembling in your fingers?

Yes No