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Any elderly patient experiencing new or worsening neurological symptoms despite B12 treatment should be referred back to their GP for reassessment, as alternative diagnoses must be considered

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Neurophysiological examination, using electrophysiology or ultrasonography, performed in certain circumstances, should correlate with the history and findings in clinical examination of the person with CTS

[11] [9] This explains why therapeutic doses are substantially higher than dietary requirements

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Treatment proves much more cost-effective once drinking is controlled