A 43-Year-Old Woman Says She Cannot Sleep Due to Pain

A 43-year-old woman says she cannot sleep due to pain and tingling affecting the first three digits of both hands.  She has no problems with her legs.  The patient suffers from chronic renal failure due to uncontrolled hypertension and receives hemodialysis.  On examination, she has bilaterally diminished sensation over the thumb, index and middle fingers, and the radial half of her ring finger.  Which of the following is the most likely mechanism of this patient's condition?

A) Endomysial inflammatory infiltration
B) Endoneural arteriole hyalinization
C) Endoneural multifocal demyelination
D) Mutations of a muscle structural protein gene
E) Nerve compression within an anatomic compartment

Correct Answer:

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