Patients may be unaware of their loss of some or all distal sensation; sensory loss may present as degrees of numbness, paraesthesia or hyperalgesia. The patient should lie relaxed on a couch throughout the assessment, and not watch the tests, in order to avoid visual prompts. Sensory evaluation should be carried out in a systematic manner, with all areas of the foot and all sensory modalities assessed. The distribution of altered sensation (. dermatomal loss; distal loss) is noted on an appropriate form retained within the patient's case notes. Where possible the same clinician should carry out any repeat tests, and repeat tests, . every 6-12 months should be made at the same time of day as the original assessment, due to the diurnal variation in sensory awareness.