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Pain oriented sensory testing

Updated: Apr 17, 2022

Key Steps:

- Work out the area/body part you wish to assess

- Are you looking at dermatomal or peripheral nerve testing site

- Neurological examination includes:

- Tone and clonus

- Power

- Reflexes

- Co-ordination

- Vibration

- Sensation - If areas of concern - continue on to POST

Sensation can be tested by light touch and pin prick

- Pain oriented sensory testing includes:

Pin prick - Punctate mechanical allodynia - Adelta

Brush - Dynamic mechanical allodynia - Abeta

Pressure testing - Pressure evoked allodynia - Adelta

Cold testing - Cold allodynia - Adelta

Light touch is Abeta

Vibration is Abeta

Sensory syndromes to watch for when completing POST:

Does the sensory change involve both sides?

- ?Polyneuropathy or spinal cord disease

Does the sensory change involve only one side?

- Contralateral brainstem, thalamus or cerebral cortex lesion

Is it a mixed picture? e.g. pain and temp loss on one side and sensory loss on the other?

- Hemisection of the spinal cord?

Is there a sensory level? (e.g. spinal cord disease or lateral medullary infarction)

Is there sensory DISSOCIATION?

- E.g. syringomyelia, spinal stroke, Brown-Sequard lesion

Is there sensory loss on the face?

- Lesion above the spinal cord most likely

- Brainstem is opposite to lesion

- Thalamus and cerebral hemisphere causes loss to same side

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