Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis

Pablo A. Baltodano, Danielle H. Rochlin, Jonathan Noboa, Karim A. Sarhane, Gedge David Rosson, A. Lee Dellon

Research output: Contribution to journalArticlepeer-review

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.

Original languageEnglish (US)
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
DOIs
StateAccepted/In press - Jul 5 2015
Externally publishedYes

Keywords

  • Leprosy
  • Nerve compression
  • Neurolysis
  • Neurosensory testing

ASJC Scopus subject areas

  • Surgery

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