Prevalence of leprous neuropathy determined by neurosensory tests

 

 Pablo A Baltodano 1Danielle H Rochlin 1Jonathan Noboa 2Karim A Sarhane 1Gedge D Rosson 1A Lee Dellon 3Affiliations expand

 J Plast Reconstr Aesthet Surg. 2016 Jul;69(7):966-71. doi: 10.1016/j.bjps.2016.03.013. 

Abstract

The success of a microneurosurgical intervention in leprous neuropathy (LN) depends on the diagnosis of chronic compression before irreversible paralysis and digital loss occurs. In order to determine the effectiveness of a different approach for early identification of LN, neurosensory testing with the Pressure-Specified Sensory Device™ (PSSD), a validated and sensitive test, was performed in an endemic zone for leprosy. A cross-sectional study was conducted to analyze a patient sample meeting the World Health Organization (WHO) criteria for Hansen’s disease. The prevalence of LN was based on the presence of ≥1 abnormal PSSD pressure threshold for a two-point static touch. A total of 312 upper and lower extremity nerves were evaluated in 39 patients. The PSSD found a 97.4% prevalence of LN. Tinel’s sign was identified in 60% of these patients. An algorithm for early identification of patients with LN was proposed using PSSD testing based on the unilateral screening of the ulnar and deep peroneal nerves.

Keywords: Leprosy; Nerve compression; Neurolysis; Neurosensory testing.

Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Karim Sarhane

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