Neuropathy Symptom Score (NSS)

Ask the patient whether they experience any of the following symptoms suggestive of neuropathy, particularly in the distal extremities.

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 location
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 quality of life or usual activities.
No impairment of quality of life or usual activities.
This question is mandatory.

Neuropathie Defizit Score (NDS)

Perform the following tests for neuropathic deficits on both feet.

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 reflex hammer.
Select one of the three options.
Normal
Reduced / present with reinforcement
Absent
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 graded Rydel-Seiffer tuning fork 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

Using a Neurotip®/Neuropen®, pinprick stimulator, or a mildly sharp everyday object (e.g., a toothpick) on the distal dorsum of the foot, including the great toe.
How many of the 10 stimuli are correctly perceived?
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

Using TipTherm®, TwinTip®, or other everyday objects with similarly shaped warm and cold surfaces applied to the dorsum of the foot:
Out of 3 warm-cold stimulus pairs, how many were correctly distinguished?
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 many of 5 or 10 monofilament applications at different non-callused sites (plantar forefoot and plantar aspects of the toes) are perceived by the patient?
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.