Sensory neurological examination is an important part of any physical examination. This part of the physical examination takes on even more importance in the workup of the patient with chronic pain. During World War II, Dr. George Riddoch, a neurologist in the British Army, developed a logical approach to the sensory examination with the concept of identifying “signature” surface areas highly correlated with specific anatomic dermatomes, which, in turn, are associated with specific nerve roots. Later, the concept of current perception threshold (CPT) was developed to quantitate level of sensory deficit. Problems developed with this diagnostic technique, however, with significant variability associated with changing skin resistance. Recently, the concept of voltage-actuated sensory nerve conduction (V-sNCT) has resulted in the development of a new instrument to quantitate sensory function.

Conventional EMG (electrical muscle graph) cannot test the nerves causing pain, which is the reason why 40% of patients seek medical help. Only 2% of pain patients have motor nerve symptoms for which EMG is effective. Massachusetts General Hospital Handbook of Pain Management 2005 "EMG/NCV cannot test small pain fibers." "In MOST cases (over 50%) of neck and back pain the anatomic and physiologic diagnosis remains unclear." Neurological Text by Weiner & Goetz Lippinott 2005 "EMG/NCV in the absence of motor symptoms, such as muscle weakness, is costly, time consuming and seldom benefits the patient."

This is the reason 43% of pain patients become chronic and 50% to 80% of back surgeries end in failures. The medical literature does not support that symptoms, physical exams, EMG/NCV or MRI can detect which nerve is causing pain. Only the AXON-II tests pain fibers!

Pain can be Incorrectly Located or Referred

At least 50% of patients misdirect doctors away from the source of pain due to referred symptoms. Over 90% of A-delta fibers reach the sensory cortex so they should allow the patient to exactly localization of the source of pain, but injury causes A-delta fiber to become numb. However, the poor localizing C-Type fiber keep functioning and can even up-regulate. The result is that 50% of patients are so confused they may even localize pain as coming from the opposite side. Guyton states; "This explains why so many patients have serious difficulty localizing the source of pain."

The AXON-II detects down-regulated A-delta function to locate injured nerve(s) with statistical sensitivity approaching 100%. The patented electrical signal selectively stimulates A-delta fibers. The highest amplitude causing an action potential indicates pathology. A potentiometer verifies firing by detecting the action potential. Since the patient is his own control, independent of age or gender and population variables, the sensitivity is as high as is possible. High potentiometer amplitudes have been reported to have a close correlation with high VAS ratings. The AXON-II can also test C and A-beta fibers, which is useful when RSD or sympathetically mediated pain syndrome is suspected.
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The information contained on this site is not intended to be a substitute for professional medical advice. Please visit Dr. Tapp prior to starting any new treatment or with any questions you may have regarding a medical condition or concern. Video Disclaimer: The testimonials contained in this production were made by persons who provided or were provided with treatment on an PainDX product. They reflect the individual experiences of the person providing the statement. Individual experiences and results may vary. Some people who provided a testimonial were paid a fee for the time spent in producing the video.

FDA Indications and Usage: The Axon-II NCSs is a diagnostic device that allows the quantitative detection of various sensory neurological impairments caused by various pathological conditions or toxic substance exposures. The subject population for whom this device can be used for diagnostic purposes includes any individual capable of communicating the perception of cutaneous sensation (with the potentiometer, which has a separate FDA clearance, the test is not dependent on the subject reporting perception of the cutaneous sensation, since the action potential of the nerve firing is detectable by the potentiometer). The Axon-IITM NCSs diagnostic examination may be conducted as part the neurological examination or for screening to detect peripheral neuropathies.

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