Authors: E. Vlčková 1,2; I. Šrotová 1,2 Authors place of work: Neurologická klinika LF MU a FN Brno 1; CEITEC – Středoevropský technologický institut MU, Brno 2 Published in the journal: Cesk Slov Neurol N 2014; 77/110(4): 402-418 Category: Minimonografie
Sensory examination represents one of the most complicated parts of clinical neurological examination that requires detailed instructions to patients and their attentive cooperation. Using correct methodology of testing and precise evaluation of the results, sensory tests frequently disclose even very fine sensory abnormities which patients may not be able to describe or even may not be aware of. The aim of this paper is to provide an overview of methods most frequently used to evaluate common sensory and pain modalities (touch, vibration and thermal sensation, thermoalgic sensation, deep pain pressure, mechanical detection threshold and sensitivity, evaluation of dynamic mechanical allodynia), including interpretation of the findings and recommended normal values (if applicable). In each of the tested modalities, most commonly used methods are described from the easiest qualitative and semiquantitative methods (usually more frequently used in clinical practice) up to more complicated quantitative tests. Main advantages of qualitative and semiquantitative methods include their low methodological and time burden and high availability of the equipment used. Quantitative sensory testing (QST) is more demanding and requires the use of specialized, not widely available, equipment. These methods, however, provide quantified results with better diagnostic validity, may disclose even less pronounced sensory abnormities and are more useful in long-term follow-up as well as in inter-individual comparisons, both at individual and group level. These methods have been widely used in recent clinical and pharmacological studies and are essential in the diagnostic process of small fiber neuropathy.
Key words: neurological examination – sensory threshold – pain threshold – normal values – small fiber neuropathy
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