'Thumb localizing test' for detecting a lesion in the posterior column-medial lemniscal system. 1999

K Hirayama, and T Fukutake, and M Kawamura
Department of Neurology, Chiba University School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, Japan.

A proprioception examination, called the 'thumb localizing test' (TLT), is described as a technique for testing 'limb localization'. With the patient's eyes closed, the examiner positions one of the patient's upper limbs (fixed limb) and asks him to pinch the thumb of that limb with the opposite thumb and index finger (reaching limb). The findings for 221 patients (423 limbs) show that: there were TLT deficits when the limb contralateral to the cerebral lesion or ipsilateral to the peripheral nerve lesion was the fixed limb, but not when the fixed limb became the reaching limb; that the deficits of limb localization found by the TLT were strongly correlated with deficits of deep or discriminative perceptions such as sense of joint position and movement and tactile cutaneous localization, but uncorrelated with sensory deficits of pain and temperature; that deficits of limb localization were apt to arise from lesions in the posterior column-medial lemniscal system at various levels in the peripheral nerves, cervical cord, brainstem, thalamus or parietal lobe; and that impairment of limb localization and other deep or discriminative sensations were occasionally dissociated. The TLT is easily done at the patient's bedside and can detect a lesion in the posterior column-medial lemniscal system. Moreover, it provides the means to examine the perceptual deficits using a motor task of the opposite limb.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009422 Nervous System Diseases Diseases of the central and peripheral nervous system. This includes disorders of the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscle. Neurologic Disorders,Nervous System Disorders,Neurological Disorders,Disease, Nervous System,Diseases, Nervous System,Disorder, Nervous System,Disorder, Neurologic,Disorder, Neurological,Disorders, Nervous System,Disorders, Neurologic,Disorders, Neurological,Nervous System Disease,Nervous System Disorder,Neurologic Disorder,Neurological Disorder
D011434 Proprioception Sensory functions that transduce stimuli received by proprioceptive receptors in joints, tendons, muscles, and the INNER EAR into neural impulses to be transmitted to the CENTRAL NERVOUS SYSTEM. Proprioception provides sense of stationary positions and movements of one's body parts, and is important in maintaining KINESTHESIA and POSTURAL BALANCE. Labyrinthine Sense,Position Sense,Posture Sense,Sense of Equilibrium,Vestibular Sense,Sense of Position,Equilibrium Sense,Sense, Labyrinthine,Sense, Position,Sense, Posture,Sense, Vestibular
D011597 Psychomotor Performance The coordination of a sensory or ideational (cognitive) process and a motor activity. Perceptual Motor Performance,Sensory Motor Performance,Visual Motor Coordination,Coordination, Visual Motor,Coordinations, Visual Motor,Motor Coordination, Visual,Motor Coordinations, Visual,Motor Performance, Perceptual,Motor Performance, Sensory,Motor Performances, Perceptual,Motor Performances, Sensory,Perceptual Motor Performances,Performance, Perceptual Motor,Performance, Psychomotor,Performance, Sensory Motor,Performances, Perceptual Motor,Performances, Psychomotor,Performances, Sensory Motor,Psychomotor Performances,Sensory Motor Performances,Visual Motor Coordinations
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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