Name of the Procedure:

Lower Extremity Neurological Exam (G8404)

Summary

A Lower Extremity Neurological Exam is a clinical procedure where a healthcare provider evaluates the nerve function in the legs to detect any abnormalities. This involves testing muscle strength, reflexes, and sensory responses.

Purpose

The exam is designed to diagnose or rule out neurological conditions affecting the lower extremities, such as neuropathy, radiculopathy, or spinal cord injuries. The goal is to identify any nerve impairments and tailor appropriate treatment plans.

Indications

• Patients experiencing leg pain, numbness, tingling, or weakness.
• Suspected conditions such as diabetes-related neuropathy, sciatica, or spinal cord compression.
• Follow-up for patients with known neurodegenerative diseases.

Preparation

• No specific fasting required.
• Continue taking prescribed medications unless directed otherwise by a healthcare provider.
• Wear comfortable clothing that allows easy access to the legs for examination.

Procedure Description

1. History and Symptoms: The healthcare provider will gather information on the patient's symptoms and medical history.
2. Physical Exam: The patient is asked to perform various movements and tasks such as walking, toe walking, and heel walking to observe muscle function.
3. Reflex Testing: A reflex hammer is used to test the knee-jerk and Achilles reflexes.
4. Sensation Testing: The provider will assess skin sensitivity to light touch, pinpricks, and possibly vibration.

5. Strength Testing: The patient will perform specific movements against resistance to evaluate muscle strength.

   No anesthesia or sedation is required for this non-invasive examination.

Duration

The procedure typically takes between 15 to 30 minutes.

Setting

This exam is usually performed in a healthcare provider's office or outpatient clinic.

Personnel

• The procedure is primarily performed by a neurologist or a trained healthcare provider.
• A nurse or medical assistant may be present to assist with the examination.

Risks and Complications

• Generally, there are no risks or complications associated with this non-invasive exam.
• Minor discomfort might occur during certain tests.

Benefits

• Helps in accurately diagnosing neurological conditions affecting the legs.
• Early diagnosis can lead to timely and effective treatment.
• Non-invasive with no recovery time required.

Recovery

• No specific recovery required.
• Patients can resume normal activities immediately after the exam.
• Follow-up appointments may be scheduled to discuss results and treatment plans.

Alternatives

• Electromyography (EMG) and Nerve Conduction Studies (NCS): Provides a more detailed analysis of nerve and muscle function but are invasive.

• Imaging studies like MRI or CT scans: Offers visual information but does not test nerve functionality directly.

  Pros and cons vary based on the patient's specific condition and the need for detailed diagnostic information.

Patient Experience

• Patients might feel mild discomfort during reflex and strength tests but not pain.
• Sensory testing may feel strange, but it is not painful.
• Providers typically explain each step to ensure patient comfort and understanding.