Any physician should be able to accurately locate nerve lesions based upon the neurological signs and symptoms at exam presentation. Having the knowledge about the spinal tracts and where they decussate is essential to track down the specific nerves.
However, this is one of the most difficult topics to master, not only for students but clinicians as well. Neuroanatomy is also one of the few topics learned in the first year of medical school that has direct application to clinical practice, especially when patients present with acute weakness or numbness.
Having a resource that explains the various spinal tracts and helps clinicians accurately locate the site of a lesion and that is also available at their fingertips is essential for any clinician.
The past week, we reviewed Nerve Whiz app the app developed by The University Of Michigan Department Of Neurology with a goal to help medical students and physicians learn motor and sensory innervations.
The same department also developed Neuro Localizer, the app we review today, which is designed to help medical students and clinicians learn neuroanatomy and identify neurological lesions based on exam findings.
Neuro Localizer follows the similar concept as Nerve Whiz app, especially regarding the simple and easy-to-use interface. But, unlike this app, Neuro Localizer is made for iOS only.
Neuro Localizer opens to a page that features an image of a gingerbread man. Yes, that's right. The little biscuit guy from a fairy tale and an oven.
Some users may find this part confusing and ask themselves if they downloaded the right app. In my opinion, presentation with Gingerbread man doesn't affect the seriousness of this app. It is actually quite refreshing approach.
Users can tap on a part of the Gingerbread man, just like on any anatomy figure. You can touch the eye, face, arm or leg to bring up a list of signs and symptoms.
The app would require users to enter more specific detail on how the symptoms manifest, i.e. if they're weak, numb, or affect reflexes, which depends on the body part chosen.
Additional questions that can be navigated through submenus include the presence of pain/temperature, vibration/position sense, as well as the most affected area (for example thumb if the hand is selected).
Once the exact problem has been selected, the app would display an animation showing the spinal tract with nerves affected, also highlighting where the nerve decussates.
Localizations are also provided in diagrams similar to those in Nerve Whiz app, except the diagrams in Neuro Localizer app are animated, not static, showing the higher level of interactivity.
Choosing the particular nerve from the list, restarts the diagram/animation, showing the exact pathway. Also, users can add up to 5 signs to observe how the relevant pathways all interact.
For me, this is the true highlight of Neuro Localizer app. The more signs you add, the lesion is likely to be in areas which all the pathways run through. This ensures that you don't miss the right parts looking for a lesion.
Possible explanations/localizations of a particular sign/symptom for different parts of the body (right arm, left leg, etc.) are listed in Suggestions section. The app would warn you if you've added more than 5 signs.
You can access all signs observed in the View/Delete Signs section. As its name suggests, signs can be removed in this section, one by one or all at once.
The purpose of the Suggestions section, however, is not entirely clear to me. It looks like the developers had some neat idea about it, but they left it unfinished.
There is also About Us section that provides more information about the developers and other apps made by The University Of Michigan Department Of Neurology.
The user interface of Neuro Localizer app is similar to UI of Nerve Whiz app - straightforward and easy to use. Users are supposed to add signs, and the app provides localizations for affected areas in easy-to-follow interactive diagrams.
Some users may find the limitation of five signs too restricting, but in my opinion, it forces users to act wisely and selective to get the most accurate results.
Also, I found the lack of any additional information related to nerve pathways, i.e. how and why each lesion causes certain signs and symptoms, a serious drawback.
Overall, Neuro Localizer is a solid app for physicians and medical students to stay on top of the knowledge about the various nerve pathways and how they can cause neurological signs and symptoms, mostly thanks to the combination of simple user interface and colorful interactive diagrams.
Benefit: Neurologists, clinicians, and medical students who want to learn how nerve pathways cause different signs and symptoms would benefit from this app