Diminished or absent vibratory sensation can be the result of a(n)
a. spinal cord lesion involving the posterior columns.
b. lesion of the thalamus.
c. immature nervous system in infants.
d. lesion in the parietal lobe.
A
Normally, the patient would be able to perceive vibration over all bony prominences. Patients over the age of 65 normally have a lower sensation of vibration, but the vibratory sense can be lost completely as a result of polyneuropathies or spinal cord lesions involving the posterior columns. Lesions of the thalamus interfere with position sense. The vibratory assessment requires the patient to be able to communicate, and so it does not apply to infants. Inaccurate touch manipulation suggests a lesion in the parietal lobe.
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