Introduction
The author published on the finger nose proprioceptive test (FNPT) in 2017.1 FNPT is a bedside test to see if patient can touch his/her nose with his/her finger when the eyes are closed (Fig 1a). Patients with proprioceptive impairment will miss the tip of the nose (Fig 1b). As an extension of that research, can proprioception be improved by enhancing the remaining sensory pathways (eg temperature, pain, vibration)?
The test and result
Materials and methods
A 30-year-old patient with generalised severe proprioceptive impairment from axonal ataxic polyneuropathy (variant of Guillain Barre syndrome). FNPT was severely positive in the left hand. He could still feel temperature reasonably well. Left fingers were immersed in ice cubes until the patient reported feeling very cold in the fingers. FNPT was repeated.
Results and discussion
There was about 75% improvement in locating the tip of the nose with the eyes closed (Fig 1c).
Conclusion
Impairment in proprioception can be improved by enhancing the remaining sensory pathway (emperature sensation in this case).
This is just a case report and further studies need to validate the finding.
Conflict of interest statement
None declared.
- © Royal College of Physicians 2019. All rights reserved.
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