Glossary of WPI terms and definitions of clinical findings

Complex Regional Pain Syndrome (CRPS) is a chronic pain condition in which high levels of nerve impulses are sent to an affected site. For a diagnosis to be made, at least 8 of 11 criteria must be met (see clause 2.14, page 11, MAA Guides), being:

1. Skin colour that is mottled or cyanotic;
2. Cool skin temperature;
3. Oedema;
4. Skin dry or overly moist;
5. Skin texture that is smooth and non elastic; 6. Soft tissue atrophy (especially at fingertips);
7. Joint stiffness and decreased passive motion;
8. Nail changes with blemished , curved or talon like nails;
9. Hair growth changes with hair falling out, longer or finer; 10. X-rays showing trophic bone changes or osteoporosis; and 11. Bone scan showing findings consistent with CRPS.

A scale used to evaluate a patient's level of awareness that indirectly indicates the extent of neurological injury. The lowest possible GCS is 3 (coma) whilst the highest is 15 (fully awake). The scale is comprised of three tests with the points for each test added:

Eye Opening - Spontaneous (4 points), to Command (3 points), to Pain (2 points) and None (1 point).

Verbal Oriented - (5 points), Confused (4 points), Inappropriate, (3 points) Incomprehensible (2 points) and None (1 point).

Motor Responses - Obeys commands (6 points), Localises pain (5 points), Withdraws to pain (4 points), Flexion to pain (3 points), Extension to pain (2 points) and None (1 point).

An early stage in the recovery process from a Traumatic Brain Injury. A transitory state, intermediate between coma and return of full consciousness, the patient is confused, disoriented and unable to lay down new memories. Duration of PTA is variable from a few minutes to many months.

A daily assessment is carried out using a PTA scale. When the person can answer all the questions correctly on three consecutive days they are considered to have emerged from PTA on the first of these three days.

Some patients are unable to achieve a perfect score on the PTA scale and this usually occurs because the patient is left with a severe memory impairment after the injury.

Severity of injury is determined as follows:

• PTA less than one hour = a mild injury
• PTA of 1 - 24 hours = a moderate injury
• PTA of 1 - 7 days = a severe injury
• PTA 1 - 4 weeks = a very severe injury
• PTA more than 4 weeks = an extremely severe injury.

Malfunction of a spinal nerve, at the nerve root. Radiculopathy is present when a claimant has two or more of the following objective physical findings:
Loss or asymmetry of reflexes;

• Positive sciatic nerve root tension signs;
• Muscle atrophy / decreased limb circumference;
• Muscle weakness which is anatomically localised to an appropriate spinal nerve root distribution; or
• Reproducible sensory loss which is anatomically localised to an appropriate spinal nerve root distribution.

The pattern of symptoms must conform with the relevant anatomical distribution. Imaging studies (C.T, M.R.I) must also support the clinical findings and be consistent with the distribution of the radicular abnormality. Reports of global pain or altered sensation throughout all of the upper or lower limbs do not follow an anatomical distribution and do not constitute radiculopathy.