A psychogenic sensory loss should be suspected in patients with sensory loss that demonstrates hyperesthesia for one modality in a given area and anesthesia for another in the same area, absolute loss of all cutaneous sensation, hyperesthesia that resolves with mild distraction, and sensory levels that correspond to the patient's body image rather than organic sensory levels. The examiner should look for abrupt midline changes, vibration asymmetry over a fixed bone that spans the midline, vibration asymmetry at a fixed midline point as the tuning fork is pivoted from one side to the other, and marked variation with repeated examination. The validity of determining a psychogenic sensory loss with these factors has been debated. y , y
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