OBJECTIVES : We have re–evaluated several neurological techniques based on the statistical analysis.
MATERIALS AND METHODS : We have established a corresponding database for the data of detail bedside neurological examination and its final diagnosis using an auxiliary diagnostic procedure. This database was created using FileMaker Pro software containing 5,938 fully neurologically examined cases. (3,438 cases of NHO Omuta hospital and 2,500 cases of Kochi medical hospital) These cases were finally diagnosed into 50 neuro–muscular disorders and each neurological findings were statistically evaluated by Chi–square test for the relationship between findings and disorders.
RESULTS : Statistical analysis reveals,
(1) Palmo–Mental
reflex
(PMR) was positive in 579 cases in 4,530 patients (12.8%), and 39 cases (0.9%) showed left–right laterality. Abnormal PMR significantly observed in Neuronal intranuclear inclusion disease (NIID) (
p<.01), Parkinson–related diseases (PRD), and multiple cerebral infarction with dementia (DMCI). (
p<.05)
(2) Rossolimo
reflex
was examined in 1,440 patients, and 152 (10.6%) showed abnormalities, which significantly appeared in patients with PRD, temporal lobe degeneration (FTLD), frontotemporal dementia (FTD) / ALS (FTD / ALS complex), and DMCI (
p<.05)
(3) Abnormal abdominal skin
reflex
(ASR) (positive with laterality) was observed in 116 cases in 1,134 patients (10.2%). Statistically significant was observed in Cerebro–vascular disease (CVD) and demyelinating disease such as MS or NMO and myelitis or myelopathy. (
p<.05)
(4) To examine cervical and lumbar radiculopathy precisely, checking for left–right difference of pronator teres and supinator muscle, and sartorius muscle in addition to the usual manual muscle testing are useful. Furthermore, checking for difference of vibratory sensation of medial and external condyle is also useful for detecting the lumbar radiculopathy.
CONCLUSIONS : Simple statistical analysis reveals several classical neurological reflexes correlate with some neurological disorders. And detail manual muscle testing is useful for detecting precise cervical and lumbar lesion. These results will improve the accuracy of bed–side neurological diagnosis.
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