**Question:** A patient has preserved light touch and absent pain and temperature over the left upper limb. This pattern of sensory loss is called-

A. Sociable
B. Insensitive
C. Glove and stocking
D. Hemiplegic

**Correct Answer:** D. Hemiplegic

**Core Concept:**

The sensory examination in neurology involves assessing the presence or absence of light touch, pain, and temperature sensation in various body regions. In this scenario, the patient demonstrates preserved light touch, indicating that the afferent sensory fibers responsible for light touch sensation (Aβ fibers) are intact. However, the patient has absent pain and temperature sensation. This pattern of sensory loss is characterized by a specific pattern of involvement, which is helpful in narrowing down the possible neurological disorders.

**Why the Correct Answer is Right:**

The correct answer is "Hemiplegic" because this pattern of sensory loss is typically seen in a condition known as hemiplegia, which is a clinical manifestation of a stroke affecting the cerebral hemisphere. In a stroke, the blood supply to the brain is interrupted, leading to tissue ischemia and subsequent neuronal death. Hemiplegia occurs when the stroke affects the primary or secondary somatosensory cortex, leading to the loss of pain, temperature, and proprioceptive sensation on one side of the body. The preserved light touch sensation is due to the sparing of Aβ fibers, which are less affected by cerebral ischemia than other sensory fibers.

**Why Each Wrong Option is Incorrect:**

A. Sociable (Option A) is not a neurological condition and does not fit the pattern described in the question.

B. Insensitive (Option B) is a vague description that does not specifically address the described pattern of sensory loss.

C. Glove and stocking (Option C) refers to the distribution of sensory loss in a specific pattern, which is different from the described pattern of preserved light touch and absent pain and temperature sensation.

**Clinical Pearl:**

In clinical practice, recognizing the specific patterns of sensory loss in neurological examinations can help in narrowing down the differential diagnosis and guide further investigations and management strategies for patients presenting with neurological symptoms. This helps in making an accurate diagnosis and providing appropriate treatment plans, ultimately impacting patient care and outcomes.