E-ISNCSCI VERSION 2 – COMING SOON (2025)
Expedited ASIA ISNCSCI Exam (E-ISNCSCI)
The E-ISNCSCI Exam was developed to provide a more rapid option for determination of the neurological level of injury (NLI) and ASIA Impairment Scale (AIS). Use of the current E-ISNCSCI exam may be appropriate in some clinical or research situations, but it is not intended to replace the full ISNCSCI. The protocol uses the same motor and sensory exam techniques as the full ISNCSCI exam, but it allows omission of a large percentage of the individual exam components. Use of the E-ISNCSCI exam requires knowledge of and training in the full ISNCSCI exam. Use of the E-ISNCSCI exam by inexperienced evaluators is not recommended. If there is any doubt as to the accuracy or reliability of the E-ISNSCI exam, or additional information is needed, a full ISNCSCI exam should be performed by a trained evaluator.
Application
The E-ISNCSCI is NOT intended to replace the full ISNCSCI exam which should be used for comprehensive characterization of SCI such as in the acute setting, on admission and discharge from rehabilitation, in patients with chronic SCI and suspected neurological changes, or for protocol- mandated clinical trials. The E-ISNCSCI MAY be appropriate, however, in some clinical or research situations. The first would be when a quick screening exam is needed for an early determination of NLI and AIS, perhaps as part of a preliminary evaluation for eligibility for an acute clinical trial (to then be followed by a full ISNCSCI per study enrollment protocol, if eligible). The second could be when a chronic and stable patient needs to have confirmed that the NLI and AIS have not changed. In some clinical settings, like monitoring daily neurological change in a patient with acute SCI in the ICU or in a patient undergoing inpatient rehabilitation, clinical judgement must be applied to determine if the most appropriate exam is a full ISNCSCI, an E-ISNCSCI, or a non-standardized limited examination. The E- ISNCSCI exam is not sufficient if full ISNCSCI data collection is required. Use of the E-ISNCSCI exam requires knowledge of and training in the full ISNCSCI exam, and use of the E-ISNCSCI exam by inexperienced evaluators is NOT recommended.
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Read More about E-ISNCSCI Version 1 (2020)
E-ISNCSCI Cases
The following cases demonstrate the sequence of performing individual exam components for the E-ISNCSCI. For teaching purposes, this testing sequence is superimposed on a completed full ISNCSCI examination with known classification. In general, these cases demonstrate the minimum amount of testing required to confirm the NLI and AIS using the E-ISNCSCI. Frequently, testing of a few additional dermatomes or myotomes is helpful to confirm that neurological levels have been correctly identified.
E-ISNCSCI Case 20-1
E ISNCSCI Case 20-2
E-ISNCSCI Case 20-3
E-ISNCSCI Case 20-4
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Contact the ASIA office – asia.office@asia-spinalinjury.org if you have any E-ISNCSCI questions.
Requests for Permission to Reprint – E-ISNCSCIIf you would like permission to reprint (examples: book chapters, clinical trials, hospital EMR, etc.) the ASIA ISNCSCI Worksheet, please complete an ASIA Permission to Reprint Form and return, with the exact image/worksheet you would like to use, to the ASIA office for review. If approved, forms will be signed and returned to you within 5 to 10 business days. If permission is not given, you will receive notice with an explanation. ASIA Permission to Reprint Form- E ISNCSCI |
