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Assessment and diagnosis of sensory disturbance
Specialist Registrar in Neurology, Royal Hallamshire Hospital, Sheffield
Clinical Senior Lecturer and Honorary Consultant Neurologist Academic Neurology Unit, University of Sheffield
E-mail: christopher.douglass{at}sth.nhs.uk
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Abstract |
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A patient may use various terms to describe sensory disturbance. Commonly used terms include numbness, pins and needles, tingling or pain. The actual area or pattern of sensory loss is more helpful in diagnosing the underlying cause, than focussing on the qualitative description of the sensory disturbance. Sensory disturbance can occur due to pathology anywhere along the sensory pathway: from the sensory cortex and deep white matter of the brain, through the spinal cord and nerve roots to the peripheral nerves (Fig. 1). Assessment of paraesthesia therefore needs to be performed in an organized manner after a careful clinical history taking, which should guide the investigations in a focused direction to answer a specific question.