Saturday, December 14, 2013

Medical issue: which are routine tests for loss of sensitivity?

Sensitivity is the property of a portion of the nervous system to receive, transmit or charge excitations. After reception territory, they differ: the shallow sensitivity (stimulants come from the external environment and act on the body surface) or deep sensitivity  (stimulants come from internal organs, muscles). By their nature, are distinguished: elementary  sensitivity, tactile, thermal, painful, epi critical.


Routine analysis including complete blood count, a summary of urine, biochemistry, antinuclear antibody titre, serum protein electrophoresis, VDRL's, chest x-ray, X-ray spine. The discovery of an apparent sensory loss is a good reason to consult a neurologist. If one is not available, the analysis depends on the body that is affected.


If they are  involved only the lower extremities, they have made computed tomography and MRI lumbar spine. Driving speed nerve diganostic procedures are completed.


If they are involved both the upper and lower extremities, it is required MRI of the cervical spine. MRI of the cervical spine is not very precise. Nervous driving speed must be measured also.


If the face has been involved, it must be made a tomography and MRI brain. Skull radiograph is useful only when they suspect a skull fracture.


Carotids and emerging vessels  angiography are very useful in evaluating cerebrovascular disease.


If peripheral neuropathy is suspected it has to be made specific analysis.


If multiple sclerosis is suspected, spinal puncture is helpful to confirm the diagnosis. A spinal puncture is useful in the diagnosis of syphilis that reaches the central nervous system.


If pernicious anemia is suspected it has to be made dosage of folic acid and vitamin B12 and possibly Schilling test.


Guillain-Barre syndrome is diagnosed by examining the cerebrospinal fluid that will show a marked increase in protein compared to cells numbers.


Syndromes such as carpal tunnel syndrome incarceration, incarceration of ulnar nerve or tarsus tunnel syndrome  are diagnosed by studying the nervous driving speed.


An Electroencephalogram sleep-waking can diagnose complex partial seizures. Sometimes the combination of Myelography
 and computed tomography is better than MRI.

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