Physical Exam

Light Touch Sensation

🎬

Video coming September 2026

How to Perform

With the patient's eyes closed, lightly touch the skin with a fingertip, applying a brief stimulus to different areas, and ask the patient to identify where they feel it each time. Compare side to side and proximal to distal. Touch rather than stroke, so that movement does not provide an extra cue.

How to Interpret

Cauda Equina Syndrome

Saddle anesthesia (reduced perianal/perineal sensation)

Rule in

InconclusiveWide CI

Rule out

Not helpful

Evidence:Limited

Lumbosacral Radiculopathy

Leg sensation abnormal

Rule in

Not helpfulNo CI

Rule out

Not helpfulNo CI

Evidence:Limited

Stroke

Focal sensory disturbance in a patient with acute dizziness

Rule in

Somewhat helpfulDerived CI

Rule out

Not helpfulDerived CI

Evidence:Limited

References

Research in progress on one or more findings above; ratings may change.

Dionne N, Adefolarin A, Kunzelman D, Trehan N, Finucane L, Levesque L, Walton DM, Sadi J. What is the diagnostic accuracy of red flags related to cauda equina syndrome (CES), when compared to Magnetic Resonance Imaging (MRI)? A systematic review. Musculoskelet Sci Pract. 2019;42:125-133. doi:10.1016/j.msksp.2019.05.004. PMID: 31132655. Corrigendum: Musculoskelet Sci Pract. 2019, PMID: 31300389.
Anderson NE, Mason DF, Fink JN, Bergin PS, Charleston AJ, Gamble GD. Detection of focal cerebral hemisphere lesions using the neurological examination. J Neurol Neurosurg Psychiatry. 2005;76(4):545-549. PMID: 15774443.
Kim JS. Patterns of sensory abnormality in cortical stroke: evidence for a dichotomized sensory system. Neurology. 2007;68(3):174-180. PMID: 17224568.
Lauder TD, Dillingham TR, Andary M, et al. Predicting electrodiagnostic outcome in patients with upper limb symptoms: are the history and physical examination helpful? Arch Phys Med Rehabil. 2000;81(4):436-441. PMID: 10768532.
Yoss RE, Corbin KB, MacCarty CS, Love JG. Significance of symptoms and signs in localization of involved root in cervical disk protrusion. Neurology. 1957;7(10):673-683. PMID: 13477342.
Jensen OH. The level-diagnosis of a lower lumbar disc herniation: the value of sensibility and motor testing. Clin Rheumatol. 1987;6(4):564-569. PMID: 3449306.
Runchey S, McGee S. Does this patient have a hemorrhagic stroke? Clinical findings distinguishing hemorrhagic stroke from ischemic stroke. JAMA. 2010;303(22):2280-2286. PMID: 20530782
Yoss RE, Corbin KB, MacCarty CS, Love JG. Significance of symptoms and signs in localization of involved root in cervical disk protrusion. Neurology. 1957;7(10):673-683. PMID: 13477342
Al Nezari NH, Schneiders AG, Hendrick PA. Neurological examination of the peripheral nervous system to diagnose lumbar spinal disc herniation with suspected radiculopathy: a systematic review and meta-analysis. Spine J. 2013;13(6):657-674. PMID: 23499340.
Navi BB, Kamel H, Shah MP, et al. Rate and predictors of serious neurologic causes of dizziness in the emergency department. Mayo Clin Proc. 2012;87(11):1080-1088. PMID: 23063099.
Wainner RS, Fritz JM, Irrgang JJ, Boninger ML, Delitto A, Allison S. Reliability and diagnostic accuracy of the clinical examination and patient self-report measures for cervical radiculopathy. Spine. 2003;28(1):52-62. PMID: 12544957.
Levack P, Graham J, Collie D, et al. Don't wait for a sensory level - listen to the symptoms: a prospective audit of the delays in diagnosis of malignant cord compression. Clin Oncol (R Coll Radiol). 2002;14(6):472-480. PMID: 12512970.
D'Arcy CA, McGee S. Does this patient have carpal tunnel syndrome? JAMA. 2000;283(23):3110-3117. PMID: 10865306.
Bickley LS, Szilagyi PG, Hoffman RM, Soriano RP. Bates' Guide to Physical Examination and History Taking. 13th ed. Philadelphia, PA: Wolters Kluwer; 2021.
Swartz MH. Textbook of Physical Diagnosis: History and Examination. 9th ed. Philadelphia, PA: Elsevier; 2025.

Research last updated September 10, 2026.