The Neurological Symptoms Score (NSS) is a prospective questionnaire which focuses on whether a neuropathy is present in the patient. It can be used to monitor a patient over time.
Method
(1) The assessment is performed by a neurologist with special training and experience in the field of peripheral neuropathy.
(2) Volunteered descriptions of symptoms are recorded verbatim.
(3) All questions are verbal without "leading the witness."
(4) Positive responses are verified by sympathetic, but nonleading, cross-examination.
(5) If there is any doubt about a symptom, then it is scored as absent (0 points).
Items
Symptoms of muscle weakness, bulbar:
(1) extraocular
(2) facial
(3) tongue
(4) throat
Symptoms of muscle weakness, limbs:
(5) shoulder girdle and upper arm
(6) hand
(7) glutei and thigh
(8) legs
Sensory disturbances, "negative" symptoms
(9) difficulty identifying objects in the mouth
(10) difficulty identifying objects in the hands
(11) unsteadiness in walking
Sensory disturbances, "positive" symptoms
(12) "numbness", "asleep feeling", "like Novocain", "prickling" – at any site
(13) pain (burning, deep aching, tenderness) at any location
Autonomic symptoms
(14) postural fainting
(15) impotence in male
(16) loss of urinary control
(17) night diarrhea
Scoring:
• presence of a symptom: 1 point
• absence of a symptom: 0 points
neurological symptom score =
= SUM(points for all 17 items)
muscle weakness subscore =
= SUM(points for first 8 items)
sensory disturbance subscore =
= SUM(points for items 9 to 13)
autonomic symptoms subscore =
= SUM(points for the last 4 items)
Interpretation:
• minimum total score: 0
• maximum total score: 16 in female, 17 in male
• The higher the score, the greater the number of symptoms indicating a possible neurological disorder.
