Positive Signs in Organic Neurological Diseases

Objective: We aimed to identify the risk factors and prevalence of positive signs on Neurological exam in patients with neurological diseases. Background: Non-specific neurological signs and symptoms are reported in patients with organic neurological diseases. The prevalence and risk factors for these findings are not fully studied. Design/Methods: We carried a prospective uncontrolled observational study to investigate the presence of 7 signs (Hoovers sign, give away weakness, Non-pyramidal weakness, Absent pronator drift, Arm drop test, Midline splitting of sensory loss, Splitting of vibration sensation) in adults with organic neurological disease who were admitted to our tertiary care hospital, enrolled patients were divided into two groups based on the presence of these signs. Results: 190 patients were enrolled between August 2014 and August 2015, 19 percent of these patients exhibit at least one positive sign, univariate analysis revealed that: young age, female gender, anxiety, history of childhood abuse, presence of sensory deficits on examination with the lack of imaging correlation with symptoms were identified as risk factors for these positive signs. Among patients positive for functional signs: Midline splitting of vibration was the most frequent sign observed, epilepsy and vascular disease patients reported the highest frequency of neurological diagnoses included in this study. While patients with epilepsy predominantly had a normal neurological examination or hemi sensory loss with positive signs, patients with stroke had baseline motor with/or without sensory deficits with positive signs. Conclusions: Non-specific positive signs are common in patients with organic neurological diseases, anxiety or sensory deficits rise among other risk factors, failure to recognize and differentiate these signs and symptoms from organic counter component of the disease could lead to misdiagnosis from functional overlay. Larger studies are required to determine the impact of positive signs in organic diseases with long-term outcomes. Disclosure: Dr. Aboud has nothing to disclose. Dr. Al-Salaimeh has nothing to disclose. Dr. Hinduja has nothing to disclose.