Validation of diagnostic methods for traumatic sensory neuropathy and neuropathic pain.

Abstract:

INTRODUCTION:We evaluated diagnostic value of sensory tests during recovery from iatrogenic sensory neuropathy using intraoperatively verified nerve injury with subjective symptoms as gold standard. METHODS:Inferior alveolar nerves were monitored neurophysiologically throughout mandibular osteotomy in 19 patients. Sensory disturbance was registered and sensation tested using clinical and quantitative sensory (QST) and neurophysiologic tests postoperatively at 1, 3, 6, and 12 months. Sensitivity, specificity, and predictive values were calculated for all tests. RESULTS:The sensitivity of clinical tests was at best 37%, with 100% specificity, but they lost diagnostic value at chronic stages. Best diagnostic accuracy (highest combination of sensitivity and specificity) at different time points was achieved by combining neurophysiologic and thermal QST or tactile and thermal QST. The single most accurate test was sensory neurography. CONCLUSIONS:Neurography or combinations of neurophysiologic and quantitative tests enables most reliable early and late diagnosis. Clinical sensory examination is inadequate for accurate diagnosis. Muscle Nerve 59:342-347, 2019.

journal_name

Muscle Nerve

journal_title

Muscle & nerve

authors

Teerijoki-Oksa T,Forssell H,Jääskeläinen SK

doi

10.1002/mus.26400

subject

Has Abstract

pub_date

2019-03-01 00:00:00

pages

342-347

issue

3

eissn

0148-639X

issn

1097-4598

journal_volume

59

pub_type

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