The physician usually diagnoses peripheral neuropathy by excluding other causes of your patient’s signs and symptoms. Typically, the physician will assess her neurologic function, evaluating her deep tendon reflexes and muscle strength and testing how well she senses temperature, light touch, sharp and dull sensations, vibration in her feet, and changes in the position of her toes.Temperature sensation in the feet and legs can be assessed by touching a cool metal object, such as a tuning fork, to the skin and asking your patient to describe the temperature. Light touch can be assessed by touching the skin with a wisp of cotton or a monofilament device and asking her to describe the location of the sensation. Sharp and dull sensation can be assessed by asking your patient to close her eyes and then alternately touching her feet with the dull and sharp ends of an object, such as a paper clip, and asking her to describe the sensation. Vibration sensation is assessed by placing a vibrating tuning fork on the distal first metatarsal head or the malleolus of your patient’s ankles and asking her to tell you when the vibration stops. To assess your patient’s position sense, ask her to close her eyes; then flex and extend her great toe and have her describe its position.