What Are the Different Types of Paresthesia Treatment?

Sensation disorders refer to difficulties and abnormalities in the process of reflecting the individual properties of stimuli. Common sensory disorders are: sensory allergy: abnormally increased ability to sense external stimuli. Feeling and lack of sensation: the ability to feel the external stimulus is reduced. Feeling wrong: producing wrong feelings about the nature of external stimuli. Internal perceptual discomfort: produce strange discomfort or pain to the internal stimulus of the body. Psychological research on the brain mechanism of sensory disorders has confirmed that the damage to the posterior region of the central sulcus in the human cerebral cortex is related to the occurrence of sensory disorders. Sensory disorders can have a wide range of effects on a person's various psychological processes, and can lead to perceptual disturbances, resulting in disturbances in motor feedback and motor dysfunction. Clinically, both neuropathy and psychiatric disorders can have sensory disturbances, the former being more common. Treatment should identify the primary disease causing the sensory disturbance and treat the cause.

Basic Information

English name

sensation disorders

Visiting department

Department of Neurology and Psychology

Common locations

Vision, smell, hearing, touch and other organs

Common symptoms

Special sensory or somatosensory system disorders

Causes of sensory disorders and common diseases

Peripheral sensory disorder

Common in the ulnar nerve, median nerve, flexor nerve damage, as well as peripheral neuritis, toxic neuritis, metabolic neuritis, lateral femoral dermatitis, polyneuritis and so on.

2. Posterior root type sensory disturbance

Common in prolapse of intervertebral discs, extraspinal tumors, syringomyelia, and trauma.

3. Spinal cord sensory disorder

Common in transmyelitis, spinal tumors, extramedullary tumors, trauma, spinal vascular disease, spinal cord compression, subacute joint degeneration, syringomyelia, and optic neuromyelitis

4. Brainstem sensory disorders

Common in brain stem vascular disease, brain stem tumors, brain stem inflammation, congenital malformations, cerebellopontine angle lesions, and so on.

5. Thalamic sensory disorder

Common in cerebrovascular disease, tumors, epilepsy, etc.

6. Inner capsule sensory disorder

Common in cerebrovascular disease, tumors, etc.

7. Cortical sensory disorders

Common in cerebrovascular disease, tumors, parietal lobe epilepsy sensory epileptic seizures, inflammation, trauma and so on.

8. Adenopathic sensory disorders

It is often found in hypersensitive people with trauma and mental stimulation.

Differential diagnosis of sensory disorders

Special feeling

These include smell, sight, hearing, taste, vestibular, or balance.

2. General feeling

(1) Superficial sensation refers to pain, temperature, and touch from the skin and mucous membranes.

(2) Deep sensation refers to the sense of movement, position and vibration from muscles, muscles, periosteum and joints.

(3) Compound sensation (cortical sensation) includes physical sensation, positioning sensation, and two-point discrimination sensation. The compound sensation can only be checked when the deep and shallow sensations are normal.

3. Visceral sensation

It is transmitted by autonomic nerves, such as hunger, nausea, and visceral colic.

Paresthesia test

Physical examination

Sensory examinations are cumbersome and prone to errors in neurological disease examinations, requiring patience and meticulousness, and sometimes repeated inspections. The examination requires the patient to be in a good mental state, conscious, and able to express normally on the examination. Before the examination, let the patient understand the method and significance of the examination, and strive for the full cooperation of the patient. Patients are asked to close their eyes or cover the part of the examination during the examination. The order of examination is generally from the sensory absence area to the normal area. During the inspection, pay attention to the comparison between the corresponding parts on the left and right sides and the far and near ends, and repeat the inspection if necessary. Feeling disorders should be recorded with charts and human contour maps so that they can be compared for reference during repeated inspections. It is necessary to distinguish the types of sensory disorders, such as conductive beam type, segmental type, nerve root type or peripheral type, and the degree of sensory disturbance. Excessive fatigue can increase the patient's sensory threshold. The inspection time should not be too long, and the inspection can be completed in several times if necessary.

(1) Superficial sensation test Touch the skin lightly with cotton wool, and touch the hair in the area covered by hair. For shallow pain, you can pierce the skin with ordinary acupuncture needles or small needles at the percussion hammer handle. Ask the patient to make a sound when they feel slight pain, and make sure that the patient feels pain rather than the touch of a sharp object. Alternate stimulation at both ends to verify. If there are areas with shallow paresthesia, multi-directional inspections are needed to verify the scope. Temperature sense: Use test tubes with cold water (5-10 ° C) and hot water (40-50 ° C) to alternately contact the skin. The patient reports cold or hot.

(2 ) Deep sensory examination Joint position sensory examiner passively moves the patient's joint and asks the patient where his limbs are. The examiner can also put the patient's limb into a posture and hold it, and instruct the patient to imitate the contralateral limb. The motion examiner gently moves the patient's fingers and toes, and asks the patient to indicate the direction of movement. The moving range is about 50, and it will increase when obstacles are found. Note that the examiner's fingers should be placed on both sides of the movement direction, and the movement should be slow, otherwise the patient may indirectly determine the direction of the finger toe movement with pressure sense, causing the illusion of unobstructed movement sense. Vibration tuning fork handle, usually 128Hz, placed on the patient's bone protrusion, and asked if there is a vibration feeling. Pay attention to the time limit of the feeling, and compare the two sides. You can also use the vibrating and non-vibrating tuning forks alternately to check their discrimination ability. Alternately touch and press down the patient's skin with a blunt object, and instruct the patient to identify. Deep pain squeezes the muscles or tendons, and can also compress the main nerve trunks. Ask the patient if there is pain, and observe whether there is a painful expression.

(3) Examination of compound sensation Position the patient with his eyes closed. After the examiner touches the patient's skin with a finger or a pen, etc., the patient points out the stimulation site with his finger. Close the eyes of the patient at two points , use a special obtuse two-legged ruler to separate their feet to a certain distance, contact the patient's skin, and gradually reduce the distance. Reduce the distance if the patient still feels two points. Normal sensitivity varies throughout the body, with the most sensitive fingertips and the worst in the back, thighs, and legs. Normal fingertips are 2 to 4mm, palms are 8 to 12mm, backs of hands are 2 to 3mm, forearms and upper arms are 7 to 8cm. Close the eyes of the physio- sensory patient, and place items such as pens, keys, coins, etc. in the patient's hands so that they can only be touched with one hand, and then name the items and test them left and right. Weight perception Two objects with a weight difference of at least twice are put into one hand successively, and patients should be distinguished. Can be compared on both sides, this test is meaningless when there is deep sensory disturbance.

2. Auxiliary inspection

Select appropriate tests according to the location and nature of sensory disturbances. Peripheral infection disorders should choose electromyography, lumbar puncture cerebrospinal fluid dynamics and routine examinations, and nerve biopsy should be performed if necessary; posterior root and spinal types should be based on sensory Select CT or MRI of the spinal cord, lumbar puncture cerebrospinal fluid examination, spinal angiography, etc .; brain stem, thalamus, inner capsule, cortical type, etc. should choose brain MRI, electroencephalography, cerebral angiography, etc .; somatosensory disorder Psychological examination should be started.

Sensory Disorder Treatment

Treatment is based on the primary disease causing the sensory disturbance.