A 45-year old patient presents to the emergency room with pain to her extremities. What type of neuropathy does she have if the pain is worse at night?

The correct choice is indicative of peripheral neuropathy. This type of neuropathy often manifests as pain, tingling, or numbness in the extremities due to conditions that affect the peripheral nerves. When a patient experiences pain that is worse at night, it is typically associated with peripheral neuropathy, as the affected nerves may become more irritated or sensitive during periods of rest and inactivity, leading to increased discomfort.

Peripheral neuropathy can arise from various causes, including diabetes, vitamin deficiencies, or exposure to toxins. The symptoms may include not only pain but also changes in sensitivity and weakness. It's also common for individuals with peripheral neuropathy to report that their symptoms worsen at night, potentially disrupting sleep.

In contrast, central neuropathy would be related to issues within the central nervous system, impacting sensory processing and eliciting different types of symptoms. Autonomic neuropathy involves disruption to the autonomic nervous system functions, which regulate involuntary bodily functions and would generally not cause the specific symptoms described. Focal neuropathy refers to nerve damage affecting a specific area and would typically present with pain or symptoms localized to one region rather than widespread pain in the extremities.