Journal article
Detailed Clinical Assessment of Neurological Function in Symptomatic Shipyard Workers
British journal of industrial medicine, Vol.47(8), pp.566-572
08/01/1990
DOI: 10.1136/oem.47.8.566
PMCID: PMC1035232
PMID: 2393637
Abstract
Forty eight patients with extensive occupational exposure to pneumatic grinding tools were evaluated at a university sponsored occupational health clinic. All patients were interviewed and examined by a physician and assessed neurologically with standard clinical, functional motor, quantitative vibrotactile, and electrodiagnostic tests. Sensorineural symptoms were nearly universal; 47 patients (98%) reported numbness and tingling of the hands and fingers. Among clinical tests, two point discrimination and 30 Hz vibration perception were most frequently abnormal. In order to evaluate associations between quantitative test results and sensorineural symptoms, patients were stratified into two groups of symptom severity according to a consensus sensorineural staging system. The tests that discriminated best between the groups of more and less symptomatic patients were hand strength dynamometry, and vibrotactile thresholds. Age standardised 120 Hz vibrotactile thresholds were significantly raised in digit II in 41% of hand measurements. Nerve conduction studies were neither significantly different between more and less symptomatic groups nor correlated with clinical and quantitative sensory tests. Twenty five per cent of the patients had slowing of sensory conduction velocities in the median nerve at the wrist (< 48 m/s). Of this subset of patients only two showed abnormal slowing of the median nerve distal to the wrist, but half also showed ulnar nerve slowing (< 47 m/s). This observation high-lights the difficulty of differentiating median nerve entrapment from diffuse distal neuropathy in workers exposed to vibration and points to the need for concomitant quantitative sensory and functional motor assessment.
Details
- Title: Subtitle
- Detailed Clinical Assessment of Neurological Function in Symptomatic Shipyard Workers
- Creators
- Martin G. Cherniack - Yale UniversityRichard LetzFredric GerrAnthony BrammerPatricia Pace
- Resource Type
- Journal article
- Publication Details
- British journal of industrial medicine, Vol.47(8), pp.566-572
- Publisher
- British Medical Association
- DOI
- 10.1136/oem.47.8.566
- PMID
- 2393637
- PMCID
- PMC1035232
- ISSN
- 0007-1072
- eISSN
- 1470-7926
- Language
- English
- Date published
- 08/01/1990
- Academic Unit
- Occupational and Environmental Health; Epidemiology
- Record Identifier
- 9984364420802771
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