Proposal for "Guidelines for the management of acute neuritis in leprosy” - Definition, symptoms and signs

Leprosy Mailing List – January 18^th, 2012 

Ref.:    Proposal for "Guidelines for the management of acute neuritis in leprosy”

            Definition, symptoms and signs

From:  A Mahé, Paris, France

---

Dear Dr Noto,

With the ongoing transfer of the leprosy control activities to the general health services, the Bulletin of the French-speaking leprologists (BALLF) aims at providing to health personnel clear and understandable outlines of some of the conditions related to leprosy they may encounter.  The diffusion of the Bulletin is covering francophone Africa, South East Asia and the Caribbean area. Proposals of all LML affiliates are welcome.

Therefore, we would like to propose in our journal standardized "Guidelines for the management of acute neuritis in leprosy".  In that perspective, and owing to the relatively high variability of practices in that specific field, it seemed to us interesting to question the affiliates of the leprosy mailing list about their practices in their institutions.

We would be very grateful for those who would let us know those practices.  A synthesis will then be performed, and communicated to the leprosy mailing list.

We have selected the following questions about definition, clinical signs and electromyography (Part I.);

1) What is your definition of 'acute leprosy neuritis' ?

 2) Which are the clinical symptoms and signs to be taken into account for justifying the implementation of a specific therapy of acute neuritis (i.e., systemic steroids):

2a - presence of pain : spontaneous ? Provoked by palpation ? Or by movement ?

2b - recent occurrence of neurological dysfunction (sensory, motor, autonomic) ?

2c Definition of "recent" ? With or without pain ?

3) Relevance of electromyography and nerve conduction studies ?

4) Strategies for early detection of incipient neuritis during follow-up of known patients ?

Thank you so much for your answers and comments,

Dr Antoine Mahé

Editor of the Bulletin of the French-speaking leprologists (BALLF)

Dr Antoine Mahé

Dermatologie

Hôpital Pasteur

39, avenue de la Liberté

68024 Colmar Cedex

Secrétariat (+33) 03 89 12 44 65 / 41 58

Fax (+33) 03 89 12 47 69

Portable (+33) 06 31 27 68 71

NB Part II Medical and surgical therapy will follow.