METHODS: for assessing neurological disturbances in the diagnosis of the hand-arm vibration syndrome are described. The clinical examination should comprise a careful history of symptoms and vibration exposure and a consideration of neurological signs known to be associated with vibration exposure. There is as yet no etiologic diagnostic method for vibration-induced neurological lesions. The best method is a relevant clinical examination as described, in combination with a quantitative assessment of sensory modalities (such as the vibration perception threshold) and an electroneuromyographic test.