Template:Quantitative Sensory Testing

Summary of choice methods of assessing nerve function per sensation.

Fibres	Sensation	Finding Descriptor	Clinical Relevance	Testing Equipment and Instructions
				Clinical	QST	Laboratory
Aβ	Touch	Dynamic mechanical allodynia	Common to most NP. Central sensitisation.	cotton wool or camel hairbrush - 2cm stroke over 1 second and repeat	Von Frey filaments	NCS, SEPs
Aβ	Vibration	Vibration detection threshold	Infrequent but strongly suggestive of NP	Tuning fork (128 Hz)	Vibrameter†	NCS, SEPs
Aδ	Pinprick, sharp pain	Punctate mechanical allodynia and hyperalgesia	Common to most NP. Central sensitisation.	Punctate mechanical allodynia - use a toothpick apply 2 stimuli per second (2 Hz) and repeat. Punctate mechanical hyperalgesia - optionally tested with a neurotips needle.	Weighted needles	LEPs, IENF
Aδ	Touch	Static or Pressure-evoked mechanical allodynia	Common to most NP, also observed in inflammatory pain. Central sensitisation.	Finger tip - apply pressure until blanching of nail bed for 1 second and repeat.	Von Frey filaments
Aδ	Cold	Cold allodynia	Infrequent but strongly suggestive of NP. Central sensitisation.	Stainless steel 128 Hz tuning fork prongs applied to the skin for 1 second and repeat	Thermode‡	None
Aδ	Touch, Pain	Temporal summation indicating hyperpathia	Central sensitisation, test for "wind-up"	Toothpick applied 2 stimuli per second (2Hz) for 30 seconds. Assess change in pre- and post- pain scores, and aftersensation.
C	Warmth	Warm allodynia	Infrequent but strongly suggestive of NP. Peripheral sensitisation.	Thermoroller or warmed C size battery at 45° applied for 1 second and repeat	Thermode‡	LEPs, IENF
† or other device providing graded vibratory stimuli ‡ or other device providing graded thermal stimuli NCS: nerve conduction studies, SEP: sensory evoked potentials, LEP: laser evoked potentials, IENF: intra-epidermal nerve fibre density. NP: neuropathic pain Modified from various sources