Painful traumatic peripheral partial nerve injury-sensory dysfunction profiles comparing outcomes of bedside examination and quantitative sensory testing.
The primary aim of this retrospective study was to focusing on the relationship between individual outcomes of bedside examination (BE) and quantitative testing of somatosensory functions (QST) in 32 patients with painful traumatic partial nerve injury. In addition, the potential presence of common sensory dysfunction denominators has been probed. Patients with a history of traumatic partial nerve injury and ongoing pain were included if pain was confined to the entire or part of the innervation territory of the severed nerve and a bedside titration of the neuron-anatomical borders confirmed sensory aberrations. An in-depth BE and QST was then performed in the most painful area. Categorization of normal and pathological outcome for both BE and QST was based on time honoured clinical decision-making using the healthy contralateral corresponding area as control. In patients with normal outcome or quantitative aberrations (i.e. hypo- or hyperesthesia) at BE and QST, the same individual outcome of touch sensation was reported by 48% of the patients, for cold in 54% and for warmth in 58%. The most common dysfunction found at both BE and QST was hypoesthesia, however with no common denominators in somatosensory dysfunction. In conclusion, this study demonstrated that not infrequently the individual outcome of BE and the corresponding QST measure differed, most frequently for touch sensibility. This finding is of outmost importance when QST outcomes are used to corroborate results from BE in the diagnostic situation.
Leffler
Ann-Sofie
AS
Section of Clinical Pain Research, Department of Molecular Medicine and Surgery, Karolinska Institutet, Pain Centre, Department of Neurosurgery, Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden. Ann-Sofie.Leffler@ki.se
Hansson
Per
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006358:Hot Temperature; D006801:Humans; D006987:Hypesthesia / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009437:Neuralgia / Q000175:diagnosis*; D009460:Neurologic Examination; D009475:Neurons, Afferent / Q000502:physiology; D059348:Peripheral Nerve Injuries; D010812:Physical Stimulation; D019095:Point-of-Care Systems; D012189:Retrospective Studies; D014110:Touch