Sensory level finding
This patient has symmetric distal sensory loss to pinprick below the mid-shins, consistent with a peripheral neuropathy.
[Doctor] Is this sharp?
[Patient] Yes.
[Doctor] Is this sharp?
[Patient] Yes.
[Doctor] Is it the same on both sides?
[Patient] Yes.
[Doctor] Is this sharp?
[Patient] No.
[Doctor] Is this sharp?
[Patient] No.
[Doctor] Is it the same on both sides?
[Patient] Yes.
[Doctor] Is this sharp?
[Patient] No.
[Doctor] Okay, let me know when you start feeling it sharp.
[Patient] Sharp.
[Doctor] Is this sharp?
[Patient] No.
[Doctor] Let me know when you start feeling it sharp.
[Patient] Sharp.
[Doctor] Okay.
About distal sensory loss
Distal sensory loss is often described as being in a stocking or stocking-glove distribution. One tests for distal sensory loss by marching the stimulus, such as a pinprick, up or down the distal aspect of the limbs.
Localization
Distal sensory loss is usually due to a generalized polyneuropathy. The longest nerves are most susceptible to conditions that affect nerve axons. As a result, sensory loss in these conditions is more pronounced distally.