...Christopher R. Brigham, MD © 2023 American Medical Association. All Rights Reserved. 2023 American Medical Association Combined Values Diagnosis-Based Impairment Lower Extremity Peripheral Nerve Impairment QUESTION: Are the multiple impairments added or combined for a patient...

... impairment to the peripheral or brachial plexus nerves are rated using Section 15.4e, Peripheral Nerve and Brachial Plexus Impairment, for upper extremities and Section 16.4c, Peripheral Nerve Rating Process, for lower extremities. Verifiable nerve lesions that incite the symptoms of complex regional pain...

...James B. Talmage, MD; Jay Blaisdell, MA; Christopher R. Brigham, MD Nerve lesions caused by traumatic events to the lower extremity's peripheral nerves are rated using Section 16.4 of the sixth edition of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides). Results from sensory...

...Kathryn Mueller, MD The AMA Guides to the Evaluation of Permanent Impairment, ( AMA Guides ) Fourth Edition, states that peripheral nerve impairments are determined by determining the percentage of the patient's motor and sensory loss. This article discusses the six steps necessary to rate...

... peripheral nerve disorder. Causalgia/CRPS II by definition involves a specific peripheral nerve disorder, and the physician can assess impairment due to pain and sensory deficit or loss of power and motor deficits by multiplying the graded percent deficit with the maximum allowable impairment...

... for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness. © 2000 American Medical Association. All Rights Reserved. 2000 American Medical Association...

... cord include electromyography (EMG), nerve conduction studies, and somatosensory evoked potentials. The primary uses of these tests are to evaluate radiculopathy, entrapment neuropathy, or other peripheral nerve study, and results must be presented completely, concisely, and in a standardized format...

...Christopher R. Brigham, MD This article discusses the evaluation of peripheral nerve impairment and focuses on assessing peripheral polyneuropathies. Although peripheral neuropathy is a common neurological disorder, no uniform criteria exist for either evaluation or diagnosis, and 30% of cases...

... each patient's unique status but requires the clinician to clearly understand the diagnosis, pathoanatomy, and expected sequelae of a condition. For example, diminished muscle function can be evaluated in four ways (gait, atrophy, weakness, and peripheral nerve injury), but impairments should...

...Richard T. Katz, MD; Sankar Perraraju, DO The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Fourth Edition, offers several categories to describe impairment in the shoulder, including shoulder amputation, abnormal shoulder motion, peripheral nerve disorders, subluxation...

...James B. Talmage, MD Upper extremity entrapment neuropathies are chronic injuries to peripheral nerves, presumably from sustained pressure on the nerve in question. These conditions are controversial, and physicians disagree, unfortunately too often, about whether a neuropathy is present, what...

... appreciate your opinion so that I can complete the review of this impairment report. Answer There is no similar statement in Chapter 16, The Upper Extremities. Since complex regional pain syndrome (CRPS I) does not follow the distribution of a specific peripheral nerve, the involvement may...

...Leon H. Ensalada, MD, MPH The cauda equina is a collection of peripheral nerves in the common dural sheath within the lumbar spinal canal. Cauda equina syndrome, also known as bilateral acute radicular syndrome, usually is caused by a large, sequestered acute disc rupture at L3-4, L4-5, or L5-S1...

... the same as in the Fourth Edition. Among important changes in the Fifth Edition regarding rating peripheral nerve impairment are: grading sensory deficits, rating entrapment neuropathies, and evaluating complex regional pain syndrome. The most noteworthy changes in assessing impairment due to other...

... person impairment values associated with these examples and gives the probable impairments based on the fifth edition. The article also discusses impairments of the peripheral nerves, amputation, and range of motion. Mastery of one chapter of the AMA Guides facilitates performing ratings using other...

... historically fastest runners. This is equivalent to axon loss, ie, partial death of the peripheral nerve since the necrotic axons will never again function. In this case, race number 1 will be won by 1 of the 5 surviving and historically slower runners (prolonged onset latency) and only 5 of the 10 runners...

...J. Mark Melhorn, MD; James B. Talmage, MD; Charles N. Brooks, MD The AMA Guides to the Evaluation of Permanent Impairment ( AMA Guides ), Sixth Edition, introduced the concept of diagnosis-based impairments (DBI), and a modified version of this method can be used in rating peripheral nerve injury...

..., comorbidities, fatigue, handedness, time of day, pain, and the individual's cooperation. The AMA Guides, Section 16.5b, Impairment Evaluation Methods, discusses the approach used for rating peripheral nerve injuries, but this section applies only to specific nerve lesions with resulting weakness of the muscles...

...Robert J. Barth, PhD, FNAN; Tom W. Bohr, MD, AAN Complex regional pain syndrome-type 1 (CRPS-1) is a problematic diagnosis of a characteristic burning pain that is present without stimulation or movement, occurs beyond the territory of a single peripheral nerve, and is disproportionate...

... may include radiographs of the cervical spine, upper chest, and/or shoulder; MRI scans of the thoracic outlet; arteriography or venography, and electrodiagnostic testing. The differential diagnosis for TOS is broad and includes cervical radiculopathy, superior sulcus tumor, other peripheral nerve...