Tactile testing device and methods

• US 5,363,859 A
• Filed: 06/10/1991
• Issued: 11/15/1994
• Est. Priority Date: 01/24/1990
• Status: Expired due to Fees

• Current Assignee: Topical Testing, Inc.
• Original Assignee: Topical Testing, Inc.
• Inventors: Fisher, John H., Horch, Kenneth W., Tuckett, Robert P., Evans, Barry L.
• Primary Examiner(s): Cohen, Lee S.
• Application Number:
  US07/713,397
• Time in Patent Office: 1,254 Days
• Field of Search: 128/736, 128/739, 128/740-742, 128/744, 128/630, 128/736, 128/739, 128/740-742, 128/744
• US Class Current: 600/552
• CPC Class Codes: A61B 5/0051 by applying vibrations
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/4824 Touch or pain perception evaluation A61B5/4821 takes precedence
• CPC Class Codes: A61B 5/4827 assessing touch sensitivity, e.g. for evaluation of pain threshold
• CPC Class Codes: A61B 5/483 by thermal stimulation

Abstract

An automatic apparatus for testing tactile responses of a patient is disclosed. The embodiments of the invention variously include components for: applying a nonambient temperature to the patient'"'"'s skin to test the patient'"'"'s response to thermal stimuli; pricking the patient'"'"'s skin to test the patient'"'"'s response to pain; indenting the patient'"'"'s skin to test the patient'"'"'s response to touch; vibrating the patient'"'"'s skin to test the patient'"'"'s response to vibration; and for making two spaced apart contacts with the patient'"'"'s skin to test the patient'"'"'s two point discrimination response. A general purpose computer and dedicated control circuits function to control the operation of the system and record the responses of the patient. The embodiments of the present invention are able to repeatedly reproduce each test so that the tests carried out are reproducible and accomplished in a minimum of time.

Claims

1. An apparatus for automatically testing the cutaneous sensory response of a patient, the apparatus comprising:

at least one stimulation means for cutaneous stimulation of the patient, said stimulation means comprising means for applying a constant current stimulus;

control means for accurately controlling the amplitude of stimulus administered by operation of the at least one stimulation means, such that stimuli of precise predetermined amplitude are administered;

means for receiving direct patient response to the stimulus administered by the stimulation means, said means for receiving direct patient response comprising means for measuring delay between stimulus and sensation;

means for recording said patient response to the stimuli; and

computer means for generating additional stimuli in response to the record of the patient response to the stimuli such that a predetermined set of data can be collected.

2. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 1 wherein said means for receiving direct patient response to the stimuli administered by the stimulation means comprises means for the patient to voluntarily indicate sensing the stimuli.

3. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 2 wherein said means for the patient to voluntarily indicate sensing the stimuli comprises a button which can be pressed by the patient.

4. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 2 wherein said means for the patient to voluntarily indicate sensing the stimuli comprises a slide which can be positioned by the patient.

5. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 1 wherein said means for receiving direct patient response to the stimuli administered by the stimulation means comprises means for monitoring physiological change in the patient.

6. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 1 wherein said means for receiving direct patient response to the stimuli administered by the stimulation means comprises means for monitoring electrical change in the patient.

7. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 1 wherein said means for receiving direct patient response to the stimuli administered by the stimulation means comprises means for measuring conduction velocity.

8. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 1 wherein said means for receiving direct patient response to the stimuli administered by the stimulation means comprises means for measuring threshold current.

9. An apparatus for automatically testing the cutaneous sensory response of a patient, the apparatus comprising:

first stimulation means for cutaneous stimulation of the patient;

second stimulation means for cutaneous stimulation of the patient;

control means for accurately controlling the amplitude and time course of stimuli administered by operation of the first stimulation means and the second stimulation means, such that stimuli of precise predetermined amplitude and time course are administered;

means for receiving direct patient response to the stimulus administered by at least one of the stimulation means, said means for receiving direct patient response comprising means for monitoring physiological change in the patient; and

computer means for recording the patient response to the first and second stimulation means for cutaneous stimulation of the patient and for generating further stimuli in response to the record of the patient response to the stimuli.

10. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 9 wherein said means for receiving direct patient response to the stimuli administered by at least one of the stimulation means comprises means for the patient to voluntarily indicate sensing the stimuli.

11. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 9 wherein said means for the patient to voluntarily indicate sensing the stimuli comprises a button which can be pressed by the patient.

12. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 9 wherein said means for the patient to voluntarily indicate sensing the stimuli comprises a slide which can be positioned by the patient.

13. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 9 wherein said means for receiving direct patient response to the stimuli administered by at least one of the stimulation means comprises means for monitoring electrical change in the patient.

14. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 9 wherein said first stimulation means for cutaneous stimulation of the patient comprises means for applying a constant current stimulus.

15. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 14 wherein said means for receiving direct patient response to the stimuli administered by at least one of the stimulation means comprises means for measuring conduction velocity.

16. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 14 wherein said means for receiving direct patient response to the stimuli administered by at least one of the stimulation means comprises means for measuring threshold current.

17. An apparatus for automatically testing the cutaneous sensory response of a patient as defined in claim 14 wherein said means for receiving direct patient response to the stimuli administered by at least one of the stimulation means comprises means for measuring delay between stimuli and sensation.

18. An apparatus for automatically testing the tactile sensory response of a patient, the apparatus comprising:

first tactile stimulation means for cutaneous stimulation of the patient;

second tactile stimulation means for cutaneous stimulation of the patient;

control means for accurately controlling the amplitude and time course of stimuli administered by operation of the first tactile stimulation means and the second tactile stimulation means such that stimuli of precise predetermined amplitude and time course are administered;

means for receiving direct patient response to the stimuli administered by at least one of the stimulation means; and

computer means for recording the patient'"'"'s responses to said first and the second tactile stimulation means for cutaneous stimulation of the patient and for generating additional stimuli in response to the record of the patient'"'"'s response to said stimuli.

19. An apparatus for automatically testing the tactile sensory response of a patient as defined in claim 18, wherein said first tactile stimulation means for cutaneous stimulation of the patient comprises a temperature means for applying a nonambient temperature to the patient'"'"'s skin.

20. An apparatus for automatically testing the tactile sensory response of a patient as defined in claim 18, wherein said first tactile stimulation means for cutaneous stimulation of the patient comprises a pinprick means for pricking the patient'"'"'s skin.

21. An apparatus for automatically testing the tactile sensory response of a patient as defined in claim 18, wherein said first tactile stimulation means for cutaneous stimulation of the patient comprises an indentation means for indenting the patient'"'"'s skin.

22. An apparatus for automatically testing the tactile sensory response of a patient as defined in claim 18, wherein said first tactile stimulation means for cutaneous stimulation of the patient comprises a vibration means for vibrating the patient'"'"'s skin.

23. An apparatus for automatically testing the tactile sensory response of a patient as defined in claim 18, wherein said first tactile stimulation means for cutaneous stimulation of the patient comprises a touch discrimination means for making two spaced apart contacts with the patient'"'"'s skin.

24. An automatic testing apparatus comprising:

a tactile stimulation means for applying stimuli to the patient'"'"'s skin;

control means for accurately controlling the amplitude of the stimuli administered by said tactile stimulation means such that stimuli of precise predetermined amplitude are administered;

means for receiving direct patient response to the stimuli administered by the tactile stimulation means;

means for recording said patient response to the stimuli; and

computer means for generating additional stimuli in response to the record of the patient response to the stimuli such that a predetermined set of data can be collected,

wherein said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing a principal modality of cutaneous sensation, said tactile stimulation means comprises temperature means for applying a nonambient temperature to the patient'"'"'s skin, and said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing the temperature modality of cutaneous sensation.

25. The automatic testing apparatus as defined in claim 24, wherein said tactile stimulation means comprises vibration means for vibrating the patient'"'"'s skin, said automatic testing apparatus capable of automatically testing the cutaneous sensory response of a patient by automatically testing the touch modality of cutaneous sensation.

26. The automatic testing apparatus as defined in claim 24, wherein said tactile stimulation means comprises constant current means for applying a constant current to the patient'"'"'s skin, said automatic testing apparatus capable of automatically testing the cutaneous sensory response of a patient by automatically testing the touch modality of cutaneous sensation.

27. An automatic testing apparatus comprising:

a tactile stimulation means for applying stimuli to the patient'"'"'s skin;

control means for accurately controlling the amplitude of the stimuli administered by said tactile stimulation means such that stimuli of precise predetermined amplitude are administered;

means for receiving direct patient response to the stimuli administered by the tactile stimulation means;

means for recording said patient response to the stimuli; and

computer means for generating additional stimuli in response to the record of the patient response to the stimuli such that a predetermined set of data can be collected,

wherein said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing a principal modality of cutaneous sensation, wherein said tactile stimulation means comprises pinprick means for pricking the patient'"'"'s skin, and said automatic testing apparatus incapable of automatically testing the cutaneous sensory response of a patient by automatically testing the pain modality of cutaneous sensation.

28. An automatic testing apparatus comprising:

a tactile stimulation means for applying stimuli to the patient'"'"'skin;

control means for accurately controlling the amplitude of the stimuli administered by said tactile stimulation means such that stimuli of precise predetermined amplitude are administered;

means for receiving direct patient response to the stimuli administered by the tactile stimulation means;

means for recording said patient response to the stimuli; and

computer means for generating additional stimuli in response to the record of the patient response to the stimuli such that a predetermined set of data can be collected,

wherein said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing a principal modality of cutaneous sensation, wherein said tactile stimulation means comprises indentation means for indenting the patient'"'"'s skin, and said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing the touch modality of cutaneous sensation.

29. An automatic testing apparatus comprising:

a tactile stimulation means for applying stimuli to the patient'"'"'s skin;

control means for accurately controlling the amplitude of the stimuli administered by said tactile stimulation means such that stimuli of precise predetermined amplitude are administered;

means for receiving direct patient response to the stimuli administered by the tactile stimulation means;

means for recording said patient response to the stimuli; and

computer means for generating additional stimuli in response to the record of the patient response to the stimuli such that a predetermined set of data can be collected,

wherein said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing a principal modality of cutaneous sensation, wherein said tactile stimulation means comprises touch discrimination means for making two spaced apart contacts with the patient'"'"'s skin, and said automatic testing apparatus is capable of automatically testing the cutaneous sensory response of a patient by automatically testing the touch modality of cutaneous sensation.