title: Assessing nerves in leprosy.
abstract: Leprosy neuropathy is dependent on the patient's immune response and expresses itself as a focal or multifocal neuropathy with asymmetric involvement. Leprosy neuropathy evolves chronically but recurrently develops periods of exacerbation during type 1 or type 2 reactions, leading to acute neuropathy. Nerve enlargement leading to entrapment syndromes is also a common manifestation. Pain may be either of inflammatory or neuropathic origin. A thorough and detailed evaluation is mandatory for adequate patient follow-up, including nerve palpation, pain assessment, graded sensory mapping, muscle power testing, and autonomic evaluation. Nerve conduction studies are a sensitive tool for nerve dysfunction, including new lesions during reaction periods or development of entrapment syndromes. Nerve ultrasonography is also a very promising method for nerve evaluation in leprosy. The authors propose a composite nerve clinical score for nerve function assessment that can be useful for longitudinal evaluation.
authors.affiliation: Coordinator of Clinical Neurophysiology Education Programm, Instituto Lauro de Souza Lima, São Paulo, Brazil. Electronic address: garbino.blv@terra.com.br.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Garbino
authors.affiliation: Senior Medical Assessor, Neurophysiology section, Fleury Institute, São Paulo, Brazil. Electronic address: carlos.heise@grupofleury.com.br.
authors.forename: Carlos Otto
authors.initials: CO
authors.lastname: Heise
authors.affiliation: Full Professor Department of Neurosciences of the School of Medicine of Ribeirão Preto-USP, São Paulo, Brazil. Electronic address: wmjunior@fmrp.usp.br.
authors.forename: Wilson
authors.initials: W
authors.lastname: Marques
mesh_terms: D003943:Diagnostic Techniques, Neurological; D006801:Humans; D007918:Leprosy / Q000150:complications*; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis* / Q000209:etiology*