| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From Department of Neurology (Drs. Pestronk, Al-Lozi, Lopate, Ramneantu, Waheed, and Stambuk, and J. Florence), Washington University School of Medicine, St. Louis, MO; Phoenix Neurological Associates (Dr. Levine), AZ; and Department of Neurology (Dr. Miller), University of Arizona College of Medicine, Tucson.
Address correspondence and reprint requests to Dr. Alan Pestronk, Washington University School of Medicine, Department of Neurology, Box 8111, 660 South Euclid Ave., St. Louis, MO 63110; e-mail: pestronk{at}kids.wustl.edu
Background: In the standard neurologic examination, outcome measures of sensation testing are typically qualitative and subjective. The authors compared the outcome of vibratory sense evaluation using a quantitative Rydel-Seiffer 64 Hz tuning fork with qualitative vibration testing, and two other features of the neurologic evaluation, deep tendon reflexes and sensory nerve conduction studies.
Methods: The authors studied 184 subjects, including 126 with Waldenström’s macroglobulinemia and 58 controls, over the course of a weekend. Standard neurologic examinations and quantitative vibratory testing were performed. Sensory nerve action potentials (SNAP) were tested as a measure of sensory nerve function. Tests were carried out by different examiners who were blinded to the results of other testing and to clinical information other than the diagnosis of Waldenström’s macroglobulinemia.
Results: Quantitative vibration measurements in all body regions correlated with sural SNAP amplitudes. Quantitative vibration outcomes were more strongly related to sural SNAP results than qualitative evaluations of vibration. Quantitative vibration testing also detected a loss of sensation with increased age in all body regions tested.
Conclusions: Quantitative vibratory evaluation with Rydel-Seiffer tuning fork is rapid, has high inter- and intrarater reliability, and provides measures for evaluating changes in sensory function over time. Examinations with the quantitative tuning fork are also more sensitive and specific than qualitative vibration testing for detecting changes in sensory nerve function. Use of the quantitative tuning fork takes no more time, provides more objective information, and should replace the qualitative vibratory testing method that is now commonly used in the standard neurologic examination.
Received July 23, 2003. Accepted in final form October 14, 2003.
This article has been cited by other articles:
|
|
 |
|
  A. J. Videler, J. P. van Dijk, A. Beelen, M. de Visser, F. Nollet, and I. N. van Schaik Motor axon loss is associated with hand dysfunction in Charcot-Marie-Tooth disease 1a Neurology, October 14, 2008; 71(16): 1254 - 1260. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T Levine, A Pestronk, J Florence, M T Al-Lozi, G Lopate, T Miller, I Ramneantu, W Waheed, M Stambuk, M J Stone, et al. Peripheral neuropathies in Waldenstrom's macroglobulinaemia J. Neurol. Neurosurg. Psychiatry, February 1, 2006; 77(2): 224 - 228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kastenbauer, M. Strupp, and M. Dichgans What to do for the neurologist who has a screw loose: Glue and the art of tuning fork maintenance Neurology, October 12, 2004; 63(7): 1328 - 1328. [Full Text] [PDF]
|
|
|
|
|
|
I. S. J. Merkies, P. I. M. Schmitz, P. A. van Doorn, A. Pestronk, J. Florence, T. Levine, M. T. Al-Lozi, G. Lopate, T. Miller, I. Ramneantu, et al. Sensory exam with a quantitative tuning fork: Rapid, sensitive and predictive of SNAP amplitude Neurology, September 28, 2004; 63(6): 1138 - 1138. [Full Text] [PDF]
|
|
Read all Correspondence
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
