Quantifying sensory loss in peripheral neuropathies.

Alterations in cutaneous sensation is the most common presentation of toxic neuropathies. The clinical assessment of cutaneous sensation can be graded only very roughly, and frequently there are wide fluctuations in findings from one examiner to another and from one examination to another in the same patients. Screening populations for sensory impairment has relied mainly upon nerve conduction studies. Limitations in this technique resulted in the development of portable instruments which can quantitate sensory thresholds. Instruments for measuring vibration, thermal and current perception thresholds will be described. These tools are able to quantitate nerve impairment at its most distal extension and also examine axon populations not reflected in nerve conduction studies.