Sensibility Evaluation in Children: Variability of Upper Limb Sensory Threshold Outcomes.

Abstract

To evaluate upper limb sensory thresholds in typically developing children with healthy upper limbs. Cross-sectional study. Tertiary referral center. Consecutive sample of 50 children with a mean age of 12.9 ± 2.7 (range, 8-19) years with the absence of known upper limb deficits. Not applicable. Weinstein Enhanced Sensory Test (WEST) sensory threshold scores in the 14 peripheral nerve dermatomes of the upper limb, dichotomized as 2.83 (normal sensation) versus > 2.83. In the first dorsal webspace, a WEST score of >2.83 was reported in 50%, and disagreement between limbs by two WEST levels (e.g., 2.83 versus 4.31) in 34%. Proximal to the wrist, sensory thresholds of 2.83 were reported in 41%; more frequently on the lateral volar side (61%) compared to the dorsal side (48%) and the medial volar side (26%) (Cochran's Q test: p<0.001); and more frequently on the distal compared to the proximal arm (52% versus 39%, McNemar's test: p<0.001). Disagreement of at least one WEST level between the dominant and non-dominant sides was reported in 55%, disagreement of at least two WEST levels in 33%. Sensory thresholds were not significantly associated with laterality, sex, age, or type of care, in the first dorsal webspace as well as proximal to the wrist. Sensory thresholds in the upper limb of children without upper limb deficits are variable, proximal to the wrist as well as in the first dorsal webspace. This should be taken into consideration when evaluating sensibility in children with peripheral nerve injuries.