title: Neuropathic pain in leprosy.
abstract: Nerve impairment is a key clinical aspect of leprosy and may present the distribution of mononeuropathy or multiple nerve trunks, small cutaneous nerve fibers, and free nerve endings. The clinical range of leprosy is determined by individual cell-mediated immune response to infection that also may play a role in different types of pain syndromes in leprosy. Previous studies reported a high prevalence of neuropathic pain in leprosy. In an Ethiopian study with 48 patients, pure nociceptive pain was experienced by 43% of patients and pure neuropathic pain (NeP) by 11% of patients. In an Indian study, 21.8% of leprosy patients had pain with neuropathic characteristics. These rates underlie the need to develop tools for the early diagnosis and detection of infection and its complications, such as nerve damage and pain. In a larger sample with leprosy-associated NeP (n = 90), we have applied the Douleur Neuropathique en 4 questions (DN4) and found sensitivity = 97.1% and specificity = 57.9%. The high sensitivity of this tool in leprosy patients suggests that it could be a valuable tool to screen for neuropathic pain in this population and could be used as part of health care programs aimed at detecting, treating, and rehabilitating leprosy in endemic areas.
authors.affiliation: Department of Neurology, Clinics Hospital of the University of Sao Paulo Medical School, Av.Dr. Éneas de Carvalho Aguiar, 255, 05403-900 Sao Paulo, Brazil.
authors.forename: Irina
authors.initials: I
authors.lastname: Raicher
authors.affiliation: Department of Neurology, Clinics Hospital of the University of Sao Paulo Medical School, Av.Dr. Éneas de Carvalho Aguiar, 255, 05403-900 Sao Paulo, Brazil.
authors.forename: Patrick Raymond Nicolas Andre Ghislain
authors.initials: PR
authors.lastname: Stump
authors.affiliation: Instituto Lauro de Souza Lima, Bauru, Brazil.
authors.forename: Rosemari
authors.initials: R
authors.lastname: Baccarelli
authors.affiliation: Instituto Lauro de Souza Lima, Bauru, Brazil.
authors.forename: Lucia H S C
authors.initials: LH
authors.lastname: Marciano
authors.affiliation: Instituto Lauro de Souza Lima, Bauru, Brazil.
authors.forename: Somei
authors.initials: S
authors.lastname: Ura
authors.affiliation: Instituto Lauro de Souza Lima, Bauru, Brazil.
authors.forename: Marcos C L
authors.initials: MC
authors.lastname: Virmond
authors.affiliation: Department of Neurology, Clinics Hospital of the University of Sao Paulo Medical School, Av.Dr. Éneas de Carvalho Aguiar, 255, 05403-900 Sao Paulo, Brazil.
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.affiliation: Department of Neurology, Clinics Hospital of the University of Sao Paulo Medical School, Av.Dr. Éneas de Carvalho Aguiar, 255, 05403-900 Sao Paulo, Brazil; Pain Group, Cancer Institute of the State of Sao Paulo, Av. Dr. Arnaldo, 251, 01246-000 Sao Paulo, Brazil. Electronic address: Ciampi@usp.br.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ciampi de Andrade
mesh_terms: D006801:Humans; D007918:Leprosy / Q000150:complications*; D009437:Neuralgia / Q000175:diagnosis / Q000209:etiology*; D011795:Surveys and Questionnaires