BARESTHESIA: ORIGIN, CONCEPT, TEST, RELATED DISORDERS - MEDICINE - 2024

The barestesia is a medical term used to describe the ability of humans to distinguish between varying degrees of pressure exerted on various points of the body. Sensitivity can be divided into superficial, deep and mixed or discriminative. Baresthesia or sensation of the perception of pressure falls within the classification of deep sensitivity.

During a neurological exploration exam, in which deep sensitivity is evaluated, specifically baresthesia, the patient will be able to tell which point of the pressure was greater or less intense.

Different ways of assessing baresthesia. Source: Flickr, Pxhere, Pixabay, Publicdomainvectors.org

If the patient's ability to pinpoint where he had the greatest pressure intensity is impaired, or the patient simply does not perceive the pressure stimulus, the individual is said to have abaresthesia.

This type of injury is frequent when there is any injury at the level of the parietal cortex. Although it is also possible if there is alteration of the receptors that send the nerve impulse of pressure in a certain place, or of a specific nerve, among other factors that prevent this information from reaching the brain.

The receptors responsible for perceiving the stimulus of the minimum intensity pressure are the Pacini corpuscles and to a lesser extent the Golgi corpuscles.

Whereas, the Golgi corpuscles are more specialized to perceive the strong pressures and to a lesser extent the Pacini corpuscles.

Origin and concept

If we break down the term baresthesia, we have that "báros" from the Greek (βάρος) means pressure and (aisthesis) means sensitivity and the ending (ia) means quality. Therefore, it can then be said that baresthesia is the quality of feeling pressure.

Baresthesia assessment test

For the baresthesia assessment test, as well as for all tests that include the neurological examination, a quiet and quiet environment is required. This ensures proper concentration for the patient and examiner.

It is also necessary that the patient is relaxed and collaborative. On the other hand, the examiner or specialist must inspire a lot of confidence, since the test requires the patient to have their eyes covered.

The specialist will explain the dynamics of the test to the patient in detail. Likewise, it is important to indicate the objective of the test and the appropriate way in which you must answer the questions. Clear and precise answers will be requested.

At no time will the specialist suggest any kind of response to the patient. This should be spontaneous at all times. If this is not met the test is not reliable.

Process

The patient must be comfortably seated to perform the test. The examiner will exert pressure with varying intensity on different places on the patient's body, such as the arms, legs or trunk. Specifically, emphasis is placed on the upper trapezius, biceps brachii, or calf muscles.

An attempt will be made to choose sites on the right and left side and it will be observed if there is a difference in responses, when applying the same intensity of pressure to both sides of the body. If this property is not affected, the patient will have no difficulty in feeling where pressure is being applied.

The test is performed very carefully, avoiding causing pain or harm to the patient.

It should be noted that there are patients who may have polyneuropathies and a simple pressure on a muscle can be a very painful experience. To exert pressure you can use the fingertip of the examiner, specifically the use of the index finger is recommended.

The patient is questioned to find out at what point he felt the most pressure. The results are recorded.

Another way of performing this test is using the cuff of the blood pressure measuring instrument, called a tensiometer, sphygmomanometer or baumanometer.

The cuff is put on and raised to a certain degree, then the pressure is increased or decreased and the patient is asked if he is now more or less pressed than before.

Other methodologies for exploration

On the other hand, when the specialist needs it, he will perform a more delicate exploration of the baresthesia, for this he will use a kind of metallic discs of different weights or the Eulenburg bartesiometer.

Metal discs

These metal discs of known weights serve to generate pressure on the patient's skin. If you don't have the metal discs, you can use coins of different sizes.

The specialist will place a stack of these discs or coins on the patient in different places.

Eulenburg Baresthesiometer

A special instrument, called a Eulenburg baresthesiometer, can also be used.

This instrument is much more precise, since it allows its use in small areas of skin, applying pressure with a fairly fine blunt tip. This device allows evaluating areas of skin where it would be impossible to place a pile of coins in perfect balance.

The instrument consists of a column that ends in a blunt point and pressing the point against the skin flattens a spring that it carries. It has a graduated scale with a needle that indicates the degree of pressure exerted.

It is based on the following: the patient with a certain sensory alteration will not feel the tip when it is simply placed on the skin, therefore, the specialist begins to generate pressure slowly but progressively, while the instrument indicates how much pressure has gone exercising.

The measurement is obtained when the patient indicates to feel the contact stimulus. It should be noted that this experience is compared with that obtained with a normal subject, this is how the decrease in the sensitivity to contact of the patient can be testified.

The patient should be able to recognize the pressure change if his baresthesia is intact.

Related disorders

Syndromes due to lesions in the parietal lobes

In pathologies that involve injury to the parietal cortex, it is common to observe that there is deterioration of tactile sensations, which includes baresthesia along with other alterations, such as: tactile agnosia, pain asymmetry, a tingling sensation or hypoesthesia, among others.

The medical conditions that can produce this type of injury and, therefore, present somatosensory alterations are: cerebrovascular accident, Guillain Barré syndrome or hemiplegia, among others.

References

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