Mr McTavish has intact gross touch on the left side of the trunk, and the proximal lower limb. He has absent tactile sensation in the left arm and hand. He cannot feel the left side when the right side is touched simultaneously. This has implications for the overuse of the unaffected side, and he may quickly lose function in his affected side.
Mr McTavish can feel movement in the left leg and can accurately describe the positions of his left hip and knee. He cannot detect movement or the position of his left arm.
Management plan:
- Care must be taken when handling and positioning limbs with altered sensation and proprioception as patients will often be unaware of the risk of trauma to the limb
- Explain to the patient the importance of protecting their limbs
- Provide appropriate tactile sensory feedback through handling and base of support e.g. pillows, towels, cushions etc
- Encourage the patient to be functionally independent as appropriate
- Prior to carrying out a weight-bearing transfer, ensure that the affected foot is well-aligned on the footplate, or floor, and that the ankle is stable
- Discuss management strategies with MDT to ensure a coordinated and consistent approach
