Rate of neurological diagnosis in patients with hemisensory syndrome – A retrospective cross-sectional study

Purpose Hemisensory syndrome (HS) is a subjective unilateral sensory abnormality that causes reduced sensation and chronic pain, with no additional objective findings, posing a diagnostic challenge. We aimed to determine the rate of neurological diagnosis among patients with hemisensory complaints and identify clinical tools to aid in the diagnosis. Methods A cross-sectional retrospective study was conducted using data collected from 194 patients who presented to the emergency department of a tertiary medical center with hemisensory complaints in 2010-2020. Their medical records were screened for demographic and clinical features and the results of all ancillary examinations. Results A neurological diagnosis was reached for 55/194 patients (28.3%), mainly acute stroke/transient ischemic attack in 24 (43.6%), migraine in 14 (25.4%), and multiple sclerosis in 13 (23.6%). The likelihood of diagnosis was not significantly affected by gender, side involvement, or use of chronic medications. Rate of pyramidal signs and mean triglyceride level were increased in the diagnosis group. Brain magnetic resonance imaging (MRI) was the largest clinical contributor to the diagnosis, demonstrating pathological findings in 59% of the diagnosis group (versus zero in the no-diagnosis group) and in 21% of all patients who underwent MRI. Conclusions The yield of extensive investigations in patients with HS is low, and in only one-fourth of cases is the etiology determined. Brain MRI appears to be the most efficient neuroimaging tool available. Addition variables need to be defined to aid clinicians in identifying patients warranting a comprehensive medical examination and in determining which tests to apply.