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针对疑似周围神经病变的床边神经学检查是否达标?

Does Your Bedside Neurological Examination for Suspected Peripheral Neuropathies Measure Up?

作者信息

Bender Cedric, Dove Lucy, Schmid Annina B

出版信息

J Orthop Sports Phys Ther. 2023 Mar;53(3):107-112. doi: 10.2519/jospt.2022.11281. Epub 2022 Oct 28.

Abstract

Neurological testing is essential for screening and diagnosing suspected peripheral neuropathies. Detecting changes in somatosensory and motor nerve function can also have direct implications for management decisions. Nevertheless, there is considerable variation in what is included in a bedside neurological examination and how it is performed. Neurological examinations are often used as screening tools to detect neurological deficits but not used to their full potential for monitoring progress or deterioration. Here, we advocate for better use of the neurological examination within a clinical reasoning framework. Constrained by the lack of research in this field, our Viewpoint is based on neuroscientific principles. We highlight 6 challenges for clinicians when conducting neurological examinations and propose ways to overcome these challenges in clinical practice. We challenge widely held ideas about how the results of neurological examinations for peripheral neuropathies are interpreted and how the examinations are performed in practice. .

摘要

神经学检查对于筛查和诊断疑似周围神经病变至关重要。检测躯体感觉和运动神经功能的变化也会对治疗决策产生直接影响。然而,床旁神经学检查的内容以及检查方式存在很大差异。神经学检查常被用作检测神经功能缺损的筛查工具,但并未充分发挥其监测病情进展或恶化的潜力。在此,我们提倡在临床推理框架内更好地利用神经学检查。由于该领域研究匮乏,我们的观点基于神经科学原理。我们强调了临床医生在进行神经学检查时面临的6项挑战,并提出了在临床实践中克服这些挑战的方法。我们对关于周围神经病变神经学检查结果的解读方式以及实际检查操作的一些普遍观点提出了质疑。

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