Acute sensory symptoms

Sensory symptoms are a result of altered perception of pain, temperature, touch or proprioception. They may be positive (dysaesthesia) or negative (hypoaesthesia). They are commonly, but not invariably, associated with weakness. Sensory symptoms can result from pathology anywhere in the nervous system, although disease processes restricted to the muscle, neuromuscular junction, or motor neuron should not produce sensory signs. The sensory examination can be difficult to perform and interpret. Directed testing to confirm or refute a predefined hypothesis can help avoid the pitfalls, for example, by specifically testing for a sensory level or ‘glove and stocking’ loss. Even so, the distribution of sensory loss can sometimes seem baffling and inconsistent with the rest of the diagnostic formulation. It is sometimes worth considering whether the diagnosis is made clearer when the sensory signs are disregarded. Functional sensory symptoms can also cause confusion.