Neuropathie Symptom Score (NSS)

Ask the patient whether she/he experiences any of the following symptoms typical of neuropathy in their feet or lower legs.

Symptoms

Select all symptoms that apply.
Burning
Feeling of numbness
Paresthesia
Feeling of weakness
Cramps
Pain
No symptoms
This question is mandatory.

Where do the symptoms occur (location)?

Select all that applies.
Feet
Lower leg
Other locations
This question is mandatory.

When do the symptoms occur (exacerbation)?

Select one of the following answers.
Only at night
During the day and at night
Only during the day
This question is mandatory.

Does the patient wake up at night due to symptoms?

Select one of the following answers.
Yes
No
This question is mandatory.

Do the symptoms improve when ... ?

Select one of the following answers.
Walking
Standing
Sitting or Lying down
No change
This question is mandatory.

Pain scale

Pain during the day (average)

Select a pain level between 0 and 10 (0 for no pain / 10 for the most severe pain imaginable).
0
This question is mandatory.

Pain at night (average)

Select a pain level between 0 and 10 (0 for no pain / 10 for the most severe pain imaginable).
0
This question is mandatory.

Quality of life

Does the pain affect your quality of life?

Yes, the pain affects my quality of life and everyday activities.
No, no impairment of quality of life or everyday life.
This question is mandatory.

Neuropathie Defizit Score (NDS)

Perform the following tests for neuropathic deficits on both sides of the patient.

Please indicate the age of the person. A minimum age of 18 is recommended.
This question is mandatory.

Achilles tendon reflex - right

with a Trömner hammer.
Select one of the two answers.
Normal
Weakened / with facilitation
Missing
This question is mandatory.

Achilles tendon reflex - left

with a Trömner hammer.
Select one of the two answers.
Normal
Weakened / with facilitation
Missing
This question is mandatory.

Vibration perception - right

using a tuning fork according to Rydel-Seiffer Dorsal at the interphalangeal joint of the big toe.
Select a value between 0 and 8.
0
This question is mandatory.

Vibration perception - left

using a tuning fork according to Rydel-Seiffer Dorsal at the interphalangeal joint of the big toe.
Select a value between 0 and 8.
0
This question is mandatory.

Pain sensation - right

with Neurotip/Neuropen, pinprick, or a sharp everyday object such as a toothpick on the distal back of the foot, including the big toe.
How often does the patient correctly perceive the pain stimuli? (in 10 attempts).
0-7 out of 10 correctly identified
8-10 out of 10 correctly identified
This question is mandatory.

Pain sensation - left

with Neurotip/Neuropen, pinprick, or a sharp everyday object such as a toothpick on the distal back of the foot, including the big toe.
How often does the patient correctly perceive the pain stimuli? (in 10 attempts).
0-7 out of 10 correctly identified
8-10 out of 10 correctly identified
This question is mandatory.

Temperature sensation - right

with TipTherm, TwinTip, or another cold everyday object (e.g., made of metal) on the back of the foot.
How often does the patient correctly identify the temperature stimuli in 3 attempts?
0/3
1/3
2/3
3/3
This question is mandatory.

Temperature sensation - left

with TipTherm, TwinTip, or another cold everyday object (e.g., made of metal) on the back of the foot.
How often does the patient correctly identify the temperature stimuli in 3 attempts?
0/3
1/3
2/3
3/3
This question is mandatory.

Risk of ulceration - right

with 10 g monofilament.
How often does the patient perceive contact with the monofilament in 5 or 10 tests at different corneal-free sites: plantar distal to the big toe and on the ball of the foot?
0-4 out of 5 tests or 0-8 out of 10 tests are perceived
5 out of 5 tests or 9-10 out of 10 tests are perceived
This question is mandatory.

Risk of ulceration - left

with 10 g monofilament.
How often does the patient perceive contact with the monofilament in 5 or 10 tests at different corneal-free sites: plantar distal to the big toe and on the ball of the foot?
0-4 out of 5 tests or 0-8 out of 10 tests are perceived
5 out of 5 tests or 9-10 out of 10 tests are perceived
This question is mandatory.

One or more mandatory questions have not been answered.