Innovative Medical Technology
How does the sNCT/CPT evaluation assist in clinical evaluations?
CPT sNCT evaluation is used to objectively quantify sensory nerve function
when the history (sensory symptoms) and physical examination (abnormalities
desp; The differential diagnosis of sensory neuropathy can include:
radiculopathy (disc injury), compressive lesion (e.g., carpal or tarsal
tunnel syndrome), as well as axonal versus demyelinating polyneuropathy
(e.g. Guillian-Barré Syndrome, diabetic, uremic, alcoholic, toxic), spinal
impairment or other types of central nervous system dysfunction (e.g.
syringomyelia). Different sensory nerve pathologies can exhibit distinctly
different distributions of sensory impairment and may selectively effect the
functioning of specific sub-populations of nerve fiber function (e.g.
demyelinating neuropathies or large versus small fiber dysfunction). For
instance, the impairment resulting from radiculopathy will be confined to a
dermatomal distribution whereas the impairment from polyneuropathy secondary
to axonopathy is most often confined to a distal distribution, involving
primarily the toes, fingers and multiple nerves. CPTs can be mapped from any
cutaneous location in order to assist in identification and diagnosis.
Patients may also have a combination of sensory neuropathies such as an
alcoholic with "Saturday Night Palsy", a diabetic with radiculopathy or a
uremic with carpal tunnel syndrome superimposed on polyneuropathy.
The objective nature of the
Neurometer® CPT sNCT exam can also help in determining if a patient has
sensory neuropathy consistent with their reported symptoms or if instead
they might be suffering possible non-neurological impairments or seeking
secondary gain. Conditions such as vascular or soft tissue lesions or
arthritis, a ligamentous sprain or muscular sprain which can include
symptoms of radiating pain, may mimic neuropathic conditions. For these
reasons, it is sometimes necessary to conduct the automated sNCT evaluation
in patients with complaints of radiating pain to confirm the differential
diagnosis in order to prescribe appropriate treatment.
Severity: The Neurometer® CPT sNCT evaluation objectively documents the
clinical severity of neurogenic abnormalities. The evaluation measures
whether the impairment is early stage neuritis (hyperesthesia or nerve
inflammation) versus late stage neuropathy, hypoesthesia (loss of function)
or anesthesia (complete loss of sensation). Serial mapping of the
distribution of impairment permits the assessment of the progression of
disease. This information guides the clinician's decision for the most
appropriate treatment and/or medical/surgical referral. Generally, the
earlier the therapeutic intervention the better the prognosis. The
Neurometer® CPT sNCT evaluation enables physicians to evaluate those sensory
fibers which mediate both pain and non-pain sensation. Both types of fibers
should be evaluated because disease conditions may selectively impair large
fiber function (position and vibratory sense) and/or smaller fiber function
(pain and temperature). The evaluation of small fiber function is also
critical for assessing protective sensation.
Intervention: The CPT evaluation is also used to monitor the efficacy
and gauge the outcome of therapeutic intervention by providing objective
serial measurements of the neuropathy, disability and neuro-regenerative
processes. The painless nature of the test ensures high patient compliance
for follow-up examinations.
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