Peripheral Neuropathy Bedside Examination – Clinical Challenges

Peripheral Neuropathy Bedside Examination – Clinical Challenges

The bedside neurological examination is an important clinical tool to assist in the diagnosis of suspected peripheral neuropathies such as radiculopathy, carpal tunnel syndrome or diabetic neuropathy. The main goal of the neurological examination is to identify a loss of action potential conductivity, which manifests as a loss of function such as hypoesthesia, muscle weakness or reduced reflexes. In contrast to a loss of function, a gain of function would present through different clinical symptoms such as the presence of hyperalgesia. However, a gain of function is not specific to neuropathies, as this can also occur during common musculoskeletal conditions such as osteoarthritis.

This paper is a viewpoint which provides suggestions to clinicians on how to improve their performance and interpretation of a neurological examination. Six common challenges are highlighted with recommendations on how to overcome them in clinical practice, while enhancing your clinical thought process and clinical methods.

Six recommendations were presented within this viewpoint to help clinicians improve and interpret the results of a neurological examination. Neurological presentations are complex and it is important for clinicians to adjust what they include based on each individual case. When used in isolation the diagnostic performance of most tests is low to moderate. However, the results of a neurological examination can, and often do, provide valuable information to clinicians and assist in providing an accurate diagnosis, monitoring patient progress, and making informed treatment decisions.

RESEARCH REVIEW: “Peripheral Neuropathy Bedside Examination – Clinical Challenges”

This paper was published in the Journal of Orthopaedic & Sports Physical Therapy (2023).

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