Altered Sensation in the Upper Limb

CLINICAL DIAGNOSTIC MANUAL

Altered sensation in the upper limb refers to any change in sensory perception, which may include numbness, tingling, pain, or complete loss of sensation in the arm, hand, or fingers.

This condition can be caused by a variety of pathologies affecting different levels of the nervous system, from the cerebral cortex to peripheral nerves. Identifying the underlying cause is crucial for effective treatment, as sensory alterations can significantly impact the patient’s functionality and quality of life.

Condition	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Contralateral cortical lesion	Sensory loss in the contralateral upper limb, associated neurological signs	Clinical history, neurological exam	Brain MRI, brain CT
Peripheral neuropathy	Numbness, tingling, pain, sensory loss in the upper limb, muscle weakness	History of chronic diseases (e.g., diabetes), physical exam	EMG, nerve conduction studies, blood tests
Spinothalamic tract lesion	Loss of pain and temperature sensation, possible preservation of touch sensation	Clinical history, neurological exam	Spinal MRI, spinal CT
Cervical or thoracic nerve root lesion	Radicular pain, sensory loss, muscle weakness, decreased reflexes	Clinical history, neurological exam	Cervical or thoracic spine MRI, nerve conduction studies
Peripheral nerve injury in the arm	Sensory loss in the territory of the affected nerve, muscle weakness, atrophy	Clinical history, neurological exam	EMG, nerve conduction studies