Sensory disturbance

Proven content

Feeling is one of the most important functions of the nervous system, which allows you to recognize and, consequently, adequately respond to various stimuli coming from the external and internal world, and to important changes taking place in the body itself. On the other hand, sensory disturbances are the most common neurological symptom.

Sensory receptors

The auditory, taste, sound and olfactory stimuli are perceived by specific sensory systems called the senses. The organ of sensation is also the skin, in which there are nerve endings that enable it to perceive mechanical, thermal or chemical stimuli acting on it. These endings are called sensory receptors. Usually they are sensitive to only one type of stimulus (e.g. mechanical) and only within a certain range of its value. Some of the receptors that are sensitive to mechanical stimuli can only respond to light touch, while others only react to heavy pressure. Similar receptors are also located in internal organs, mainly in the viscera, and in the musculoskeletal system, i.e. joints, ligaments, tendons and muscles.

Types of feeling

Due to the type of stimuli received, we can distinguish basic types of feeling:

1. surface sensation (external stimuli),
2. deep sensation (stimuli from the musculoskeletal system and viscera),
3. teleceptive feeling – here stimuli are perceived by the basic sensory organs (e.g. seeing, hearing),
4. visceral sensation – stimuli are perceived by receptors located in internal organs and blood vessels.

Stimuli acting on the receptors lead to the formation of impulses in them, which are transmitted through the nerves to the central nervous system. On the basis of the analysis of the incoming impulses, appropriate sensations and reflex reactions arise. The analysis of information reaching the nervous system is performed at various stages, the so-called sensory pathway. The basic assessment is made at the level of the spinal cord (posterior horn), and the next ones at the level of brain structures such as the thalamus and the cerebral cortex.

Considering the type and level of damage, sensation can be:

1. weakened to the point where it is completely absent,
2. sharpened, which leads to hyperalgesia, i.e. much more intense than normal perception of stimuli.

It can also take the most unpleasant form of pain or distorted feeling for the patient. The concept of distorted sensation includes sensations that under normal conditions do not occur at all, and are called generally paresthesias (tingling, numbness, etc.).

Sensory disturbance – what is it actually?

Sensory disturbances can refer to all its types, therefore we distinguish its main types. Sensory disturbances may be defective in nature, then one or more types of sensation are weakened or completely eliminated. Another type of disorders are the so-called excess symptoms, which are characterized by abnormal sensations (hand numbness and tingling) or hypersensitivity to sensory stimuli (e.g. the patient feels pain when touched).

What are the most common sensory disturbances?

1. Phantom pain – these are pain symptoms occurring at the site of the amputated organ, usually it is an amputated limb. These disorders may be very strong causalgia.

2. Auzalgia – is a disorder that is characterized by very severe pain, almost burning. Pain worsens when the patient touches the sensitive area. The skin in this area is red and dry. We should also mention causalgia, which is the result of irritation of the peripheral nerve or the median nerve.

3. Paresthesia – this is one of the most popular sensory disorders that occur due to abnormal perception of ordinary stimuli – even the most delicate touch is perceived by a sick person as pain or stinging. Patients complain of a feeling of tingling, tingling and numbness. Paresthesias usually attack spontaneously without a specific stimulus and indicate neurological and physiological symptoms (e.g. prolonged stay in the same position).

4. From Nerwo – these are violent and acute disorders described as passing electricity, burning or tearing (sciatica). We can classify neuralgia as intercostal neuralgia and trigeminal neuralgia.

5. Hyperpathia – this is a disorder otherwise known as sensory hypersensitivity. In some people, its intensity is so strong that even a small touch that is normally imperceptible causes acute pain that may continue even after the stimulus has ceased to work.

What are the causes of the sensory disturbance?

Sensory disturbances can take place in various diseases. The most common causes of sensory disturbances are:

1. prolapse of the disc – refers to the lumbar spine and causes symptoms resembling sciatica, i.e. very strong pains that radiate from the loins to the buttock (even the foot). In addition, the prolapse of the disc causes paraesthesia and a significant weakening of superficial sensation located in the area of ​​the sciatic nerve innervation;
2. mechanical injuries – paraesthesia and pain ailments usually occur in the area of ​​the damaged nerve;
3. pressure on peripheral nerves, nerve roots or sensory brain structures in the course of an aneurysm, tumor or abscess – degenerative changes in the spine like to place pressure, especially on nerve roots. Patient develops pain that travels along the length of the nerve and gets worse when passing stools or coughing;
4. vitamin B12 deficiencies in the body – are the basic symptom of deep sensation disorders;
5. Guillain-Barry Syndrome – is a condition associated with polyneuritis in which there are sensory disturbances. Apart from them, limb paresis, paralysis of the facial nerve, and even vegetative symptoms may occur. At the beginning of the disease, patients experience superficial sensory disturbances manifested by paresthesia of the toes. On the other hand, at an advanced stage, patients are not able to determine the position of their hand without eye control, nor are they able to determine which finger they are holding for;
6. cerebral vascular ailments – these include: hemorrhagic stroke, subarachnoid hemorrhage and ischemic stroke. Complex sensory disturbances appear as a result of central damage, then there are difficulties in locating the site of a given stimulus and its strength. The patient is unable to determine exactly where he is being touched and whether it is a strong or a weak touch. It is also difficult to guess the signs written on the skin and to distinguish between two simultaneously acting stimuli. Vascular disorders of the brain can also lead to problems with recognizing hand-held objects (without eye control). If the lesions attack the thalamus, the patient suffers from severe hemiplegia;
7. spinal cord injuries, which include:

– transverse damage to the spinal cord – manifested by the loss of all types of sensation (deep and superficial) below the site where the spinal cord was damaged;

– intramedullary damage – deep and to the touch remain unchanged, while the feeling of pain and temperature are disturbed. Damage may result from traumatic hemorrhage;

– hemiform damage to the spinal cord – may occur as a result of multiple sclerosis, and the sensory disturbances occur below the site of damage. Disturbances in the sense of touch and deep sensation are usually located on the side of the injury, and temperature and pain on the other side;

– damage to the posterior cords of the spinal cord – may occur as a result of vitamin B12 deficiency. There are problems with impaired deep sensation, as well as incoherence of movements and reduced muscle tension.

Sensory disturbance – diagnosis

Sensory disturbances can occur for many reasons, so any patient who complains about abnormal sensation should consult a primary care physician. He will decide what problem we are dealing with and will order tips on how to proceed. Typically, the patient is referred to a neurosurgeon or neurologist.

The basis for diagnosis is a medical interview with the patient and a physical examination with a neurological examination. Additional tests are also recommended, and their type depends on the patient’s symptoms and clinical situation. The additional ones include:

1. X-ray of the spine to determine what degenerative changes we are dealing with and whether there is a hernia of the intervertebral disc,
2. magnetic resonance imaging,
3. computed tomography,
4. blood and urine tests
5. examination of the cerebrospinal fluid with the help of a lumbar puncture. The fluid is then subjected to morphological and biochemical analysis, cultures are collected, and cytological and immunological tests are carried out,
6. encephalographic examination (neurological diagnostics)
7. electromyographic examination.

Sometimes it is necessary to consult an ophthalmologist and MRI of the head.

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