The face-hand test: a useful addition to the psychiatric physical examination

The Face-Hand Test is a quick and simple neurological test which can be used to detect organic mental disorders. It is based on the principle that when light touch stimuli are simultaneously applied to the cheek and the hand, patients with organic mental disorders frequently report only the face stimulus. In other words, the hand stimulus is frequently extinguished. The test is conducted with the patient's eyes closed. For clinical purposes, ten consecutive face-hand (e.g., left cheek, right hand) combinations are applied and one point is awarded for each time the patient correctly localizes both stimuli. A score of six or less is considered a positive test. In this study, the Face-Hand Test was performed, by a blind tester, to eighty five admissions to psychiatric inpatient units at the Calgary General Hospital. Subsequently, a chart review was done, by a reviewer unaware of the test scores, and the presence or absence of an organic mental disorder was ascertained. In this sample, the sensitivity of the test for the detection of organic disorders was 87% and the specificity was 84%. The negative predictive value of the test was 97%, indicating that the test may be quite useful for the purpose of ruling out organic mental disorders among psychiatric admissions.