Neurological Examination
of the Leg 15: Sensation (Vibration)
Vibration
sense:
- Use a low pitched tuning fork
(128Hz: the longest one).
- Test with a non-vibrating
tuning fork first to ensure that the patient is responding
to the correct stimulus.
- Place the stem of the fork
over the distal interphalangeal joint of the patient's big
toes.
- Ask the patient to tell you
if they feel the vibration.
- If vibration sense is impaired
proceed proximally:
- Medial malleoli
- Patellas
- Anterior superior iliac spines
- If vibration sense is impaired,
this suggests dorsal column loss.
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