leprosy neuropathy
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2022 ◽  
Vol 16 (1) ◽  
pp. e0010070
Author(s):  
Izabela Jardim Rodrigues Pitta ◽  
Mariana de Andrea Vilas-Boas Hacker ◽  
Ligia Rocha Andrade ◽  
Clarissa Neves Spitz ◽  
Robson Teixeira Vital ◽  
...  

Introduction Pure Neural Leprosy (PNL) is a rare clinical form of leprosy in which patients do not present with the classical skin lesions but have a high burden of the disability associated with the disease. Clinical characteristics and follow up of patients in PNL are still poorly described in the literature. Objective This paper aims to describe the clinical, electrophysiological and histopathological characteristics of PNL patients, as well as their evolution after multidrug therapy (MDT). Methods Fifty-two PNL patients were selected. Clinical, nerve conduction studies (NCS), histopathological and anti-PGL-1serology were evaluated. Patients were also assessed monthly during the MDT. At the end of the MDT, all of the patients had a new neurological examination and 44 were submitted to another NCS. Results Paresthesia was the complaint most frequently reported by patients, and in the neurological examination the most common pattern observed was impairment in sensory and motor examination and a mononeuropathy multiplex. Painful nerve enlargement, a classical symptom of leprosy neuropathy, was observed in a minority of patients and in the motor NCS axonal injuries, alone or in combination with demyelinating features, were the most commonly observed. 88% of the patients did not present any leprosy reaction during MDT. There was no statistically significant difference between the neurological examinations, nor the NCS pattern, performed before and after the MDT. Discussion The classical hallmarks of leprosy neuropathy are not always present in PNL making the diagnosis even more challenging. Nerve biopsy is an important tool for PNL diagnosis as it may guide therapeutic decisions. This paper highlights unique characteristics of PNL in the spectrum of leprosy in an attempt to facilitate the diagnosis and management of these patients.


2021 ◽  
Author(s):  
Gigi J. Ebenezer ◽  
David M. Scollard
Keyword(s):  

2021 ◽  
Vol 92 (3) ◽  
pp. 236-246
Author(s):  
Erik Post ◽  
Inge Wagenaar ◽  
Wim Brandsma ◽  
Bob Bowers ◽  
Khorshed Alam ◽  
...  

Author(s):  
Juliana Barroso-Freitas ◽  
Pedro Arthur da Rocha Ribas ◽  
Paula Frassinetti Bessa Rebello ◽  
Silmara Navarro-Pennini

2020 ◽  
Vol 27 (3) ◽  
pp. 125-130
Author(s):  
Marianna Cossi Monseff Borela ◽  
Milton Cury Filho ◽  
Daniel Rocco Kirchner ◽  
Manuel Henrique Salgado ◽  
Marcos da Cunha Lopes Virmond ◽  
...  

Leprosy  neuropathy  may  develop  into  subacute  and  chronic  inflammatory  scenarios, called reactions, which may cause entrapments in the anatomic tunnels.  Objective: This study describes the late nerve conduction findings  in patients with ulnar neuropathy at the elbow that were submitted to clinical and surgery treatments.  Methods: A total of 27 nerves  of  21  patients  with  borderline  leprosy  during  type  1  (reversal)  reaction  were selected in a non- competing retrospective cohort for three years. The nerves with treated clinically   active   neuropathy (Group   A1) were   randomized   for   inclusion   of   surgical treatment (Group A2) after one month of clinical treatment without clear signs of clinical and neurophysiological improvement. Fifteen nerves were randomly chosen for surgery while  12  were  clinically  treated,  after  steroids  treatment  without  expected  response. Nerve conduction was measured before and after treatment on four occasions. Results: The authors observed significant improvement in the following variables in the surgically treated nerves: compound motor action potential amplitude (CMAP) at elbow and above elbow and conduction velocity (CV) along the forearm.  Conclusion: The improvement of CMAP amplitudes and conduction velocity (CV) along the forearm express the late effect of nerve decompression. Persistence of temporal dispersion (TD) along  the  elbow  was  related  to  the  new  reaction  or  to  incomplete  surgical  solution. However, moderate  reduction  in  CV  along  the  elbow,  without  TD,  was  considered an indication  of na expected  partial  remyelination.  Previous  gradation  of  the  nerve  lesion  based  on  the CMAP amplitude was related to the most severe results.


2019 ◽  
Vol 90 (4) ◽  
pp. 364-370
Author(s):  
Muthu Sendhil Kumaran ◽  
Manisha Thapa ◽  
Tarun Narang ◽  
Mahesh Prakash ◽  
Sunil Dogra

2019 ◽  
Vol 95 (1122) ◽  
pp. 225-226
Author(s):  
Salini Sumangala ◽  
Esmail Nikfekr ◽  
Jithin George ◽  
Christopher William Holmes
Keyword(s):  

2019 ◽  
Vol 40 (7) ◽  
pp. 1371-1375
Author(s):  
Alberto Balestrino ◽  
Pietro Fiaschi ◽  
Niccolò Riccardi ◽  
Marco Camera ◽  
Pasquale Anania ◽  
...  

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Pitta Izabela Jardim Rodrigues, ◽  
Andrade Ligia Rocha ◽  
Silveira Raquel Custódio ◽  
Giesel Louise Mara ◽  
Antunes Sergio Luiz Gomes ◽  
...  

2017 ◽  
Vol 88 (3) ◽  
pp. 373-380 ◽  
Author(s):  
Suchana Marahatta ◽  
Sabina Bhattarai ◽  
Bishnu Hari Paudel
Keyword(s):  

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