Summary

All bedside sensory findings are subjective except the corneal reflex. Remember:

• Sensory examination should be of brief duration, with brief instructions, and brief answers.

• In peripheral nerve lesions touch and superficial pain are most likely to be abnormal.

• In posterior root lesions position sense, passive movement, and, to a lesser extent, vibration sense will be abnormal.

• In spinal cord disease superficial pain and temperature, sense of passive movement, and vibration will be affected, depending on what area of the cord is diseased, with relative preservation of touch. When touch is lost because of cord disease, the patient usually cannot walk.

• In parietal lobe lesions discriminatory sensations are abnormal. These are: sense of passive movement, number writing, two-point discrimination, stereognosis, tactile or pain localization, and the recognition of two simultaneous stimuli on homologous body parts. It is not possible to say which of these is most likely to be abnormal in any particular lesion.

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