Abnormal Finding
If the screening test is abnormal you need to perform detailed evaluation to document site, distribution and exactly which sensation is impaired. This information is helpful in determining the etiology for the abnormality.
- Loss of all sensations in a symmetrical and distal distribution.Glove and stocking type ( Peripheral neuropathy).
- Loss of all sensation in the distribution of one peripheral nerve (Mononeuropathy).
- Loss of all sensation in a dermatome (root lesion).
- Loss of pain and temperature with preservation of other senses. Central cord (Syringomyelia).
- Loss of position and vibration (Dorsal column or its afferent nerves).
- Ipsilateral loss of position and vibration and contralateral loss of pain and temperature below the level of lesion. Transection of half of spinal cord (Brown-Sequard syndrome).
- Bilateral loss of all sensations below a level (Transection of spinal cord).
- Loss of all sensations on the opposite side of lesion Hemianesthesia (Thalamic lesion).
- Loss of cortical sensation on opposite side with some decrease in other sensations. (Parietal cortex lesion)
- Check for double simultaneous stimulation
- Graphesthesia
- Stereognosis