Rationale
Patients often present with altered sensation, such as numbness or tingling, as an isolated concern. Such symptoms may result from a range of underlying causes, some of which are serious.
Causal Conditions
(list not exhaustive)
- Peripheral neuropathy (e.g., diabetic neuropathy, carpal tunnel syndrome, radiculopathy)
- Central nervous system disorders (e.g., multiple sclerosis)
- Dermatologic conditions (e.g., herpes zoster infection, angioedema)
- Mental disorders (e.g., panic disorders)
Key Objectives
Given a patient presenting with altered sensation, such as numbness or tingling, the candidate will diagnose the cause, severity, and complications, and initiate an appropriate management plan.
Enabling Objectives
Given a patient with altered sensation, such as numbness or tingling, the candidate will
- list and interpret critical clinical findings, including those based on
- a history that is relevant to potential underlying causes (e.g., diabetic risk factors, workplace risk factors, distribution of symptoms, psychological stress), and
- a physical examination including a thorough neurologic examination;
- list appropriate investigations and interpret the results of the investigations (e.g., fasting glucose level, nerve conduction studies) while recognizing that investigations may not be required in many cases;
- construct an effective initial management plan based on the working diagnosis, including
- providing appropriate continuing assessment and ongoing care,
- determining if the patient requires specialized care, and
- advising the patient on work-related issues if necessary.