The sensitivity and specificity of the neurological examination in polyneuropathy patients with clinical and electrophysiological correlations
| Autor: | Vera Bril, Hana Albulaihe, Abdulla Alsulaiman, Leif E. Lovblom, Danah Aljaafari, Majed Alabdali, Ari Breiner, Alon Abraham, Hans D. Katzberg |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Physiology lcsh:Medicine Social Sciences 0302 clinical medicine Nerve Fibers Animal Cells Reflexes Medicine and Health Sciences Medicine Psychology 030212 general & internal medicine lcsh:Science Musculoskeletal System Clinical Neurophysiology Neurons Multidisciplinary medicine.diagnostic_test Physics Classical Mechanics Middle Aged Electrophysiology medicine.anatomical_structure Physical Sciences Nerve conduction study Legs Female Sensory Perception medicine.symptom Anatomy Cellular Types Polyneuropathy Research Article Weakness medicine.medical_specialty Physical examination Neurological examination Sensitivity and Specificity Vibration 03 medical and health sciences Vibration perception Polyneuropathies Internal medicine Humans Aged Retrospective Studies business.industry lcsh:R Limbs (Anatomy) Nerve Conduction Study Ankles Cognitive Psychology Biology and Life Sciences Cell Biology medicine.disease Ankle jerk reflex Electrophysiological Phenomena Cellular Neuroscience Cognitive Science lcsh:Q Perception Ankle Clinical Medicine business 030217 neurology & neurosurgery Neuroscience |
| Zdroj: | PLoS ONE PLoS ONE, Vol 12, Iss 3, p e0171597 (2017) |
| ISSN: | 1932-6203 |
| Popis: | Introduction Polyneuropathy is one of the most prevalent neurologic disorders. Although several studies explored the role of the neurological examination in polyneuropathy, they were mostly restricted to specific subgroups of patients and have not correlated examination findings with symptoms and electrophysiological results. Objectives To explore the sensitivity and specificity of different neurological examination components in patients with diverse etiologies for polyneuropathy, find the most sensitive combination of examination components for polyneuropathy detection, and correlate examination findings with symptoms and electrophysiological results. Methods Patients with polyneuropathy attending the neuromuscular clinic from 01/2013 to 09/2015 were evaluated. Inclusion criteria included symptomatic polyneuropathy, which was confirmed by electrophysiological studies. 47 subjects with no symptoms or electrophysiological findings suggestive for polyneuropathy, served as controls. Results The total cohort included 312 polyneuropathy patients, with a mean age of 60±14 years. Abnormal examination was found in 95%, most commonly sensory findings (86%). The most common abnormal examination components were impaired ankle reflexes (74%), vibration (73%), and pinprick (72%) sensation. Combining ankle reflex examination with vibration or pinprick perception had the highest sensitivity, of 88%. The specificities of individual examination component were generally high, excluding ankle reflexes (62%), and vibration perception (77%). Abnormal examination findings were correlated with symptomatic weakness and worse electrophysiological parameters. Conclusion The neurological examination is a valid, sensitive and specific tool for diagnosing polyneuropathy, and findings correlate with polyneuropathy severity. Ankle reflex examination combined with either vibration or pinprick sensory testing is the most sensitive combination for diagnosing polyneuropathy, and should be considered minimal essential components of the physical examination in patients with suspected polyneuropathy. |
| Databáze: | OpenAIRE |
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