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Vibration perception thresholds in entrapment and toxic neuropathies.

Authors
Bleecker-ML
Source
J Occup Med 1986 Oct; 28(10):991-994
NIOSHTIC No.
00165345
Abstract
Use of the modified Optacon tactile stimulator for measurement of perception thresholds as an index of subclinical disease in entrapment and toxic neuropathies is reviewed. It is noted that these frequent problems encountered in occupational neurology are difficult to objectively quantify. Use of nerve conduction velocity for documenting the severity of an impairment in the peripheral nervous system is described. However, nerve conduction studies may be insensitive early in the disease process. Design of the Optacon tactile stimulator and its use are described. Studies of vibration perception threshold are cited which demonstrate an increase in these thresholds with age. Increased thresholds are also reported to correlate with peripheral neuropathy in 38 percent of subjects examined. Studies suggest that routine neurological examination and electrodiagnostic studies are more sensitive indicators of idiopathic peripheral neuropathy than vibration perception thresholds. A Study of 56 alcoholic outpatients revealed diminished sensation in a glove distribution in 62 percent of the patients and diminished sensation in a stocking distribution in 96 percent. Identification of carpal tunnel syndrome in workers exposed to neurotoxic substances or cumulative repetitive trauma of the upper extremities is discussed. Vibration perception thresholds in the compromised index finger can be compared with the ipsilateral uninvolved ulnar innervated fifth finger. As an objective measure of nerve dysfunction in carpal tunnel syndrome, the Optacon is reported to have a sensitivity of 79 percent and a specificity of 100 percent. Use of the Optacon to distinguish toxic polyneuropathy from entrapment neuropathy is discussed. The author concludes that this tool allows detection and serial quantification of sensory abnormalities in the workplace, allowing for measurement of deterioration or improvement, and recommends that studies of possible confounding factors be performed.
Keywords
JOCMA7; NIOSH-Publication; NIOSH-Grant; Occupational-health; Occupational-health-programs; Peripheral-nervous-system; Nervous-system-disorders; Vibration-effects; Medical-monitoring; Medical-examinations; Medical-screening;
Contact
Environmental Health Sciences, Johns Hopkins University, 615 North Wolfe Street, Baltimore, MD 21205
CODEN
JOCMA7
Publication Date
19861001
Document Type
Journal Article
Funding Amount
9038560
Funding Type
Grant
Fiscal Year
1987
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-T15-OH-007090
Issue of Publication
10
ISSN
0096-1736
Source Name
Journal of Occupational Medicine
State
MD
Performing Organization
Johns Hopkins University, Baltimore, Maryland
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