How does the sNCT/CPT evaluation assist in clinical evaluations?


Differential Diagnosis: The Neurometer^® 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. Determining Clinical 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. Monitoring Therapeutic 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. top of page Previous page Home

Differential Diagnosis: The Neurometer^® 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.

Determining Clinical 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.

Monitoring Therapeutic 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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