Components of the Total Neuropathy Score (TNS)
| Component . | TNS parameters . | ||||
|---|---|---|---|---|---|
| 0 . | 1 . | 2 . | 3 . | 4 . | |
| Sensory symptoms | None | Limited to fingers or toes | Extend to ankle or wrist | Extend to knee or elbow | Above knees/elbows |
| Motor symptoms | None | Slight difficulty | Moderate difficulty | Require help/assistance | Disabled |
| Autonomic symptoms, n | 0 | 1 | 2 | 3 | 4 or 5 |
| Pin sensation | Normal | Reduced in fingers or toes | Reduced up to wrist/ankle | Reduced up to elbow/knee | Reduced above elbow/knee |
| Vibration sensibility | Normal | Reduced in fingers or toes | Reduced up to wrist/ankle | Reduced up to elbow/knee | Reduced above elbow/knee |
| Strength | Normal | Mild weakness | Moderate weakness | Severe weakness | Paralysis |
| Tendon reflexes | Normal | Ankle reflex (AR) reduced | AR absent | AR absent, other reflexes reduced | All reflexes absent |
| QST vibration sensation | Normal to 125% ULN | 126%-150 % ULN | 151%-200 % ULN | 201%-300 % ULN | >300% ULN |
| Sural a-SAP | Normal or reduced <5% | 76%-95% of LLN value | 51%-75% of LLN value | 26%-50% of LLN value | 0%-25% of LLN value |
| Peroneal a-CMAP | Normal or reduced <5% | 76%-95% of LLN value | 51%-75% of LLN value | 26%-50% of LLN value | 0%-25% of LLN value |
| Component . | TNS parameters . | ||||
|---|---|---|---|---|---|
| 0 . | 1 . | 2 . | 3 . | 4 . | |
| Sensory symptoms | None | Limited to fingers or toes | Extend to ankle or wrist | Extend to knee or elbow | Above knees/elbows |
| Motor symptoms | None | Slight difficulty | Moderate difficulty | Require help/assistance | Disabled |
| Autonomic symptoms, n | 0 | 1 | 2 | 3 | 4 or 5 |
| Pin sensation | Normal | Reduced in fingers or toes | Reduced up to wrist/ankle | Reduced up to elbow/knee | Reduced above elbow/knee |
| Vibration sensibility | Normal | Reduced in fingers or toes | Reduced up to wrist/ankle | Reduced up to elbow/knee | Reduced above elbow/knee |
| Strength | Normal | Mild weakness | Moderate weakness | Severe weakness | Paralysis |
| Tendon reflexes | Normal | Ankle reflex (AR) reduced | AR absent | AR absent, other reflexes reduced | All reflexes absent |
| QST vibration sensation | Normal to 125% ULN | 126%-150 % ULN | 151%-200 % ULN | 201%-300 % ULN | >300% ULN |
| Sural a-SAP | Normal or reduced <5% | 76%-95% of LLN value | 51%-75% of LLN value | 26%-50% of LLN value | 0%-25% of LLN value |
| Peroneal a-CMAP | Normal or reduced <5% | 76%-95% of LLN value | 51%-75% of LLN value | 26%-50% of LLN value | 0%-25% of LLN value |
a-SAP indicates amplitude of sensory action potentials; a-CMAP, compound muscle action potential; LLN, lower limit of normal; and ULN, upper limit of normal.