OPTIMIZATION OF STUDYING SENSORY DISORDERS BY MEDICAL STUDENTS
DOI:
https://doi.org/10.11603/m.2414-5998.2024.4.15137Keywords:
pain sensitivity; tactile sensitivity; neurological examination; standardized maps of sensitivity disorders; medical students.Abstract
Abstract. Objective assessment of tactile and pain sensitivity often poses challenges to medical students due to the subjective nature of the patient’s sensations during receptor stimulation. Comparing the patient’s self-assessment of sensitivity disorders with the physician's evaluation during an objective examination could provide a clearer picture of existing sensitivity disorders. To this end, a self-assessment method was proposed. Moreover, the correlation between the results of this method and the objective examination could reduce the time required for patient evaluation. The aim: To investigate the correspondence between the results of the self-assessment of pain and tactile sensitivity by the patient and the objective examination by the physician. Methods and Materials: We have assessed pain and tactile sensitivity in 53 patients (31 males, 22 females) aged 22 to 75 years (mean age 43.5 ± 14.8) with sensitivity disorders impairments associated with central and peripheral nervous system pathology: peripheral neuropathies – 33 (62.26%), multiple sclerosis – 12 (22.64%), consequences of stroke – 5 (9.43%), intramedullary spinal cord tumors – 2 (3.77%), and syringomyelia – 1 (1.89%). Standardized maps with options for sensitivity disturbances in various anatomical regions were used during the study. Patients marked the areas of altered pain and tactile sensitivity, which were compared by the physician with the results of the clinical-neurological examination. Results: The self-assessment methods aligned with the results of the objective examination in 36 patients (67.92%), partially in 10 (18.86%), and did not align in 7 (13.2%). The chi-square test (χ²) showed a statistically significant difference between groups of central and peripheral nervous system injuries regarding the conformity of the self-assessment methodology (χ² = 13.3, p = 0.001). Conclusions: The self-assessment method for pain and tactile sensitivity can be applied in routine practice for patients with peripheral nervous system involvement, unlike patients with central nervous system lesions, who require additional objective examination.
References
Al Nezari, N. H., Schneiders, A. G., & Hendrick, P. A. (2013). Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy: a systematic review and meta-analysis. The spine journal : official journal of the North American Spine Society, 13(6), 657–674. https://doi.org/10.1016/ j.spinee.2013.02.007 DOI: https://doi.org/10.1016/j.spinee.2013.02.007
Attal, N., Bouhassira, D., & Baron, R. (2018). Diagnosis and assessment of neuropathic pain through questionnaires. The Lancet. Neurology, 17(5), 456–466. https://doi.org/10.1016/ S1474-4422(18)30071-1 DOI: https://doi.org/10.1016/S1474-4422(18)30071-1
Baehr, M., Frotscher, M. (2019). Topical Diagnosis in Neurology: Anatomy, Physiology, Signs, Symptoms. Thieme; 6th edition.
Bender, C., Dove, L., & Schmid, A. B. (2023). Does Your Bedside Neurological Examination for Suspected Peripheral Neuropathies Measure Up?. The Journal of orthopaedic and sports physical therapy, 53(3), 107–112. https://doi.org/10.2519/ jospt.2022.11281 DOI: https://doi.org/10.2519/jospt.2022.11281
Blumenfeld, H. (2010). Neuroanatomy through clinical cases. Oxford University Press; 2nd edition.
Brun, C., Traverse, É., Granger, É., & Mercier, C. (2021). Somatosensory deficits and neural correlates in cerebral palsy: a scoping review. Developmental medicine and child neurology, 63(12), 1382–1393. https://doi.org/10.1111/ dmcn.14963 DOI: https://doi.org/10.1111/dmcn.14963
De Stefano, G., & Truini, A. (2024). An overview of diagnosis and assessment methods for neuropathic pain. Presse medicale (Paris, France : 1983), 53(2), 104234. https://doi.org/10.1016/ j.lpm.2024.104234 8. Erickson, M., Lawrence, M., Jansen, C. W. S., Coker, D., Amadio, P., & Cleary, C. (2019). Hand Pain and Sensory Deficits: Carpal Tunnel Syndrome. The Journal of orthopaedic and sports physical therapy, 49(5), CPG1–CPG85. https://doi.org/10.2519/ jospt.2019.0301
Ivaniuk, A., Solodovnikova, Y., Marusich, T., & Son, A. (2021). The impairment of the functional system and fatigue at the onset of the disease predict reaching disability milestones in relapsing-remitting multiple sclerosis differently in female and male patients. Acta neurologica Belgica, 121(6), 1699–1706. https://doi.org/10.1007/ s13760-020-01478-0 DOI: https://doi.org/10.1007/s13760-020-01478-0
Kessner, S. S., Bingel, U., & Thomalla, G. (2016). Somatosensory deficits after stroke: a scoping review. Topics in stroke rehabilitation, 23(2), 136–146. https://doi.org/10.1080/10749357.2015.1116822 DOI: https://doi.org/10.1080/10749357.2015.1116822
Klingner, C. M., & Witte, O. W. (2018). Somatosensory deficits. Handbook of clinical neurology, 151, 185–206. https://doi.org/10.1016/B978-0- 444-63622-5.00009-7 DOI: https://doi.org/10.1016/B978-0-444-63622-5.00009-7
O’Brien, M. D. et al. (2000). Aids to the examination of the peripheral nervous system. Saunders Ltd.; 4th edition.
Toyka, K. V., Claßen, J., Schneider, L., Saur, D. (2020). E-Book: The Neurological Examination German Society for Neurology. Manual of the Neurological Examination for Neurologists in Training (version 3.0).
Welte-Jzyk, C., Pfau, D. B., Hartmann, A., & Daubländer, M. (2018). Somatosensory profiles of patients with chronic myogenic temporomandibular disorders in relation to their painDETECT score. BMC oral health, 18(1), 138. https://doi.org/10.1186/ s12903-018-0601-8 DOI: https://doi.org/10.1186/s12903-018-0601-8
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Medical Education

This work is licensed under a Creative Commons Attribution 4.0 International License.