Screening for Medical Disease—Nervous System Disorders

Narrative ReviewIn general, nervous system disorders present with changes in sensation, strength, and cognitive function that must be recognized early for the timely referral often needed for optimal outcome. This article summarizes screening for nervous system disorders in patients who present to the hand therapist and the typical findings associated with common neurologic disorders. Recommendations for referral by the hand therapist of patients with a screening examination consistent with a nervous system disorder are also presented. Central nervous system (CNS) disorders discussed in this article include stroke, traumatic brain and spinal cord injury, CNS tumors, Parkinson disease, dementia, epilepsy, and multiple sclerosis. This is followed by a discussion of the peripheral nervous system (PNS) disorders of acquired and hereditary polyneuropathies, Guillain–Barré syndrome and myasthenia gravis. Lastly, there is a brief discussion of amyotrophic lateral sclerosis, a disorder affecting both the CNS and PNS.Level of Evidence5.