Graphesthesia is the ability to recognize writing on the skin purely by the sensation of touch. Its name derives from Greek graphē ("writing") and aisthēsis ("perception"). Graphesthesia tests combined cortical sensation; therefore, it is necessary that primary sensation be intact bilaterally .Blumenfeld, H. (2010). 'Neuroanatomy Through Clinical Cases' (2nd Edition ed.). Sunderland, Massachusetts: Sinauer Associates Inc. During medical or neurological examination graphesthesia is tested in order to test for certain neurological conditions such as; lesions in nerve roots, peripheral nerves, brainstem, spinal cord, sensory cortex or thalamus. An examiner writes single numbers or simple letters on the skin (usually the palm) with something dull like the back of pen, pen light, tongue depressor,  etc. Prior to the start of testing, an agreement must be reached between the examiner and the patient as to the orientation of the letters . During testing , the examiner should gently wipe the palm between each drawing to clearly indicate to the patient that a new letter or symbol is being drawn.O'Sullivan, S. B., Schmitz, T. J. (2007). 'Physical Rehabilitation' (5th Edition ed. ). Philadelphia: F.A. Davis Company. The patient provides a verbal response identifying the figure that was drawn. If the patient has a speech or language impairment that prevents him from verbalizing an answer, the answer can be selected from a series of images shown to him. Most people are able to determine the letters that are being written on the skin. In cases where the patient is unable to correctly identify the letters (agraphesthesia), he/she would be referred to a specialist for further evaluation. Loss of graphesthesia indicates either parietal lobe damage on the side opposite the hand tested or damage to the dorsal columns pathway at any point between the tested point and the contralateral parietal lobe  .
Graphesthesia is the ability to recognize writing on the skin purely by the sensation of touch. Its name derives from Greek graphē ("writing") and aisthēsis ("perception"). Graphesthesia tests combined cortical sensation; therefore, it is necessary that primary sensation be intact .Blumenfeld, H. (2010). 'Neuroanatomy Through Clinical Cases' (2nd Edition ed.). Sunderland, Massachusetts: Sinauer Associates Inc. During medical or neurological examination graphesthesia is tested in order to test for certain neurological conditions such as; lesions in brainstem, spinal cord, sensory cortex or thalamus. An examiner writes single numbers or simple letters on the skin (usually the palm) with something that will provide a clear stimulus, such as a broken tongue depressor, pen cap etc. Prior to the start of testing, an agreement may be reached between the examiner and the patient as to the orientation of the letters , although this is often unnecessary, since orientation and size of the figures are rarely an issue. The crucial aspect of testing graphesthesia, as with any sensory testing, is to establish that the patient understands the test, hence the test is commenced, in the hemiplegic patient, on the normal, intact hand. This also allows the examiner to establish the patient's numeracy, since semi-numerate patients may have difficulties performing the task. The patient provides a verbal response identifying the figure that was drawn. If the patient has a speech or language impairment that prevents them from verbalizing an answer, the answer can be selected from a series of images shown to them. Loss of graphesthesia indicates either parietal lobe damage on the side opposite the hand tested or damage to the dorsal columns pathway at any point between the tested point and the contralateral parietal lobe . The major clinical utility of the test in the 21st century is in the condition,cortico-basal ganglionic degeneration, where, in addition to evidence of basal ganglia dysfunction, the presence of cortical sensory loss is likely to have reasonably high specificity for the diagnosis .
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bilaterally
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nerve roots, peripheral nerves,
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dull like the back of pen, pen light,
that will provide a clear stimulus, such as a broken
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pen cap
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must
may
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. During testing , the examiner should gently wipe the palm between each drawing to clearly indicate to the patient that a new letter or symbol is being drawn.O'Sullivan, S. B.,
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Schmitz, T. J. (2007). 'Physical Rehabilitation' (5th Edition ed. ). Philadelphia: F.A. Davis Company.
, although this is often unnecessary, since orientation and size of the figures are rarely an issue. The crucial aspect of testing graphesthesia, as with any sensory testing, is to establish that the patient understands the test, hence the test is commenced, in the hemiplegic patient, on the normal, intact hand. This also allows the examiner to establish the patient's numeracy, since semi-numerate patients may have difficulties performing the task.
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him
them
R
him. Most people are able to determine the letters that are being written on the skin. In cases where the patient is unable to correctly identify the letters (agraphesthesia), he/she would be referred to a specialist for further evaluation.
them.
A
. The major clinical utility of the test in the 21st century is in the condition,cortico-basal ganglionic degeneration, where, in addition to evidence of basal ganglia dysfunction, the presence of cortical sensory loss is likely to have reasonably high specificity for the diagnosis