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Sensory disturbances can take many forms. It is possible both to impaired perception of various sensory stimuli (e.g. touch, pain or temperature) and significantly increased sensation of various sensations as well as experiencing unusual sensations that are referred to as paraesthesia (e.g. tingling, burning). Just like the types of sensory disorders, there are also a relatively large number of their causes. What tests can diagnose sensory disorders and what treatment can be offered to a patient struggling with them?

Sensory disturbancesmay occur both in the case of damage to individual nerves as a result of an injury, and as a result of systemic diseases leading to the destruction of numerous nerve fibers.

Feeling is actually quite complex, and at the same time extremely important for people's life sense - thanks to it we are able to receive various types of stimuli from the environment, which allows us, for example, to avoid factors that are dangerous for the body (as an example, you can mention withdrawal after it comes dangerously close to a burning candle).

Sensory experiences are perceived by several different types of receptors, which are:

  • exteroreceptors: receptors located primarily in the skin, which are responsible for the reception of tactile, thermal, painful stimuli and - in the case of the tongue - taste stimuli,
  • introreceptors: they are located in various internal organs, where they mainly perceive pain stimuli,
  • proprioreceptors: receptors that can be found, among others, in in muscles, joints and articular ligaments, thanks to them a person is able to determine the position of different parts of the body in relation to each other, as well as feel vibrations and recognize the shape of touched objects without looking at them,
  • telereceptors: structures that deal with the reception of stimuli from a certain distance, including the receptors present in the eye, hearing and the organ of smell.

The whole process of receiving sensory experiences is quite complicated - the usual sensation of a pin prick on a part of the body involves receptors that register such a stimulus, nerve cells that receive such information first, as well as centers located in the spinal cord andthe cortex of the brain.

Sensory disturbances may appear when one of the elements involved in the perception of sensory experiences is damaged.

Sensory disturbance - causes

Disturbances in sensation can be caused by damage to single nerve fibers (mononeuropathies) and destruction of numerous nerves (which in turn is referred to as polyneuropathy).

The first of the problems listed above include, for example, entrapment syndromes such as carpal tunnel syndrome, mononeuropathy can also develop as a result of damage to a single nerve fiber due to some limited trauma.

Polyneuropathies, which are the cause of sensory disturbances, may, in turn, develop in the course of many different systemic diseases - among the pathologies that can lead to them, the following can be mentioned:

  • diabetes,
  • vitamin B12 deficiency,
  • multiple sclerosis,
  • amyloidosis,
  • celiac disease,
  • sarcoidosis,
  • HIV infection,
  • damage to peripheral nerves as a result of chemotherapy.

Sensory disturbances may develop not only when nerve fibers are damaged, but also when some higher levels of the nervous system are damaged.

Among the problems, the symptoms of which are sensory disturbances, here are:

  • spinal cord injuries,
  • compression of the nerve roots coming out of the spinal cord (e.g. due to a prolapsed disc),
  • transverse myelitis,
  • stroke,
  • damage to the sensory centers of the cerebral cortex by an intracranial tumor.

Sensory disturbance - symptoms and types

Symptoms of sensory disturbances may include both increased perception of certain sensory stimuli (hyperesthesia) and decreased perception of them (hypoaesthesia). Due to exactly what kind of sensation the problem is about, there are many different types of sensory disturbances.

The term analgesia is the inability to feel pain, while the decreased feeling of pain is called hypalgesia. The opposite of these phenomena is hyperalgesia, i.e. increased perception of pain stimuli.

When sensory disturbances concern tactile stimuli, the perception of such stimuli may be weakened (hypesthesia) or the feeling of touch may be completely absent (abaesthesia). One of the disorders of the sense of touch is also hyperesthesia, which means that the patient becomes overly sensitive to tactile stimuli.

Sensory disturbances may also affect temperature: patients may have a reduced temperaturethe ability to feel it, i.e. thermohypoesthesia, and not to feel any thermal stimuli at all, which is referred to as thermoanaesthesia.

Causalgia and allodynia are quite interesting sensory disorders. Causalgia occurs when the fibers of the autonomic nervous system are damaged along with the sensory fibers.

In the course of this pathology, the patient experiences severe burning pain, usually accompanied by skin changes in the form of reddening and shiny skin, as well as increased sweating in the area of ​​the body affected by the disease.

Allodynia is a phenomenon in which stimuli that typically do not cause pain lead to the patient experiencing even severe pain.

The group of sensory disturbances also includes paresthesias. They can occur with or without a stimulus, and include feeling quite unusual, sometimes unpleasant, sensations such as numbness, feeling cold or warm, or tingling.

Other sensory disorders are allesthesia - patients with this problem perceive one type of stimulus as completely different (e.g. touch leads them to feel cold).

Sensory disturbance - diagnosis

A patient who develops some sensory disturbances should be looked after by a neurologist. Initially, it is necessary to determine exactly what type of problem appeared in him - this can be ascertained during a neurological examination.

The test of sensation - contrary to appearances - is quite complicated, but in practice just carrying it out allows us to make a guess which part of the nervous system has been damaged.

The feeling of touch can be assessed, for example, with the use of a piece of cotton wool, the feeling of temperature is tested, among others with the use of cool and warmer material. For example, sterile needles can be used to test the sensation of pain, while the sensation of vibration is tested with the use of a tuning fork.

To check if the patient feels the position correctly, they are asked to close their eyes, and then the examiner lifts up or points down, e.g. his fingers and asks what position his finger is in at a given moment .

It should be emphasized here that the test of sensation takes quite a long time, because it is really necessary to assess the feeling in different parts of the body (on the trunk, upper and lower limbs, back), additionally the feeling on both sides of the body should be checked.

Neurological examination, as already mentioned, may enable protrusionhypotheses about the cause of sensory disturbances. Usually, however, in order to make a specific diagnosis, it is necessary to conduct other, even more detailed tests. Among the tests that are ordered in the diagnosis of sensory disorders, the following can be mentioned:

  • laboratory tests (including measurements of blood glucose, vitamin B12, liver enzymes, but also blood counts, tests of cerebrospinal fluid or tests of antibodies related to autoimmune diseases and markers of inflammation are also valuable),
  • evoked potential research,
  • electroneurography (conduction study in sensory fibers),
  • imaging tests (such as computed tomography or magnetic resonance imaging - various structures of the nervous system can be imaged depending on where the damage is suspected, both brain and spinal cord imaging are useful in diagnostics),
  • electromyography,
  • electroencephalography (EEG).

Sensory disturbance - treatment

Accurate diagnosis in patients with impaired sensation is essential. Only after finding the cause of the problem, it is possible to offer the patient an appropriate treatment.

The influences recommended for patients can be really different, for example in the case of carpal tunnel syndrome it is sometimes necessary to undergo surgery. In patients with polyneuropathy caused by decompensated diabetes, it is necessary to intensify treatment and try to improve disease control in order to prevent further nerve damage.

Systematic rehabilitation may also bring beneficial effects in patients with various sensory disorders.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Neurology