Protocolo diagnóstico de las parestesias y disestesias

Abstract

Paresthesias are abnormal sensory perceptions in the absence of specific sensory stimuli whereas dysesthesias are abnormal perceptions of real sensory stimuli. When a patient presents with paresthesias and dysesthesias, the manner in which the symptoms started must first be determined and a neurological examination be performed to determine if the abnormality is central or peripheral and if it requires urgent, time-sensitive care (vascular symptoms, spinal cord injuries, acute inflammatory demyelinating polyradiculopathy). If the paresthesia or dysesthesia affect the majority of a limb or if they are associated with signs of cortical dysfunction (hemianopia, sensory extinction, etc.) or signs of primary motor neuron involvement (hyperreflexia, clonus, or extension plantar reflex), they would initially point to a central abnormality. On the other hand, if the paresthesia or dysesthesia is limited to part of a limb and the area affected is concordant with the skin area innervated by one or several sensory roots of the spinal nerves (dermatome) or by one or various sensory skin nerves and, on the neurological examination, there are no signs of primary motor neuron involvement (normal reflexes, areflexia, hyporeflexia, flexion plantar reflex), they would initially point to a peripheral abnormality.