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Quantitative Autonomic Testing
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The spoon test: a valid and reliable bedside test to assess sudomotor function.

Ramesh K Khurana1, Colin Russell2

  • 1Department of Medicine, MedStar Union Memorial Hospital, 201 East University Parkway, Baltimore, MD, 21218, USA. lyn.camire@medstar.net.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|February 12, 2017
PubMed
Summary

The spoon test effectively screens for sweating abnormalities. This bedside method is practical for assessing sweating, particularly on the forehead and chest, offering high sensitivity and specificity.

Keywords:
AutonomicSpoon testSudomotorThermoregulatory sweat test

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Area of Science:

  • Neurology
  • Dermatology
  • Clinical Assessment

Background:

  • Sudomotor function is crucial for thermoregulation.
  • Accurate assessment of sweating is vital for diagnosing various neurological and dermatological conditions.
  • Bedside tests offer a convenient alternative to laboratory-based assessments.

Purpose of the Study:

  • To validate the accuracy of bedside sudomotor tests.
  • To compare the sensitivity and specificity of different tactile and visual bedside sweating tests.
  • To determine the clinical utility of the spoon test for assessing sweating.

Main Methods:

  • A prospective study involving 130 subjects with generalized sweating and 16 with anhidrosis.
  • Five bedside tests were evaluated: unaided eye examination, light reflection, ophthalmoscope, skin palpation, and the spoon test.
  • Comparison of bedside test results against the gold standard thermoregulatory sweat test.

Main Results:

  • The spoon test demonstrated superior sensitivity compared to other bedside methods.
  • Sensitivity for the spoon test was highest at the neck (86%), followed by the chest (58%) and forehead (51%).
  • Specificity of the spoon test was nearly 100%, with exceptions at the chest (81%) and neck (50%).

Conclusions:

  • The spoon test is a clinically practical and valuable bedside screening tool for evaluating sweating.
  • It is particularly useful for assessing sweating on the forehead and chest.
  • Further methodological considerations may refine its application in clinical practice.