Indications for neurologic and psychiatric eval discussion
Inexplicable or ill defined upper extremity complaints may reflect an
undiagnosed neurologic or psychiatric disorder. Slowly progressive nervous
system diseases or psychiatric disorders may show little in the way of
objective abnormalities on examination, but may result in unexplained
difficulties with coordination, sensation, or pain. Stress in the workplace
is also increasingly recognized as a contributing, if not primary
explanation for many painful work related complaints. Formal
neuropsychiatric evaluation may be indicated in patients with bizarre or
inexplicable complaints. This is not to provide a verdict that there is
nothing wrong with the patient, but to survey for cognitive problems
which impact the patient's work-place safety and identify uncommon
progressive neurologic disorders (such as a brain tumor) which might have a
limited window of opportunity for cure.
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