Leprosy Mailing List – August 29, 2013
Ref.: (LML) Is the detection of nerve function loss high on the agenda?
From: S. Noto, Ragusa, Italy
Thank you and all other contributors to the LML very much. In my opinion the fact, that several of us have the detection of early nerve function loss high on the agenda, is not a proof that the situation is similar in the field. In my experience (mostly in Africa) this key issue is much neglected. It is essential to assess loss of sensation as good as possible. In sophisticated area’s it may be sensory nerve conduction or evoked signals in the brain, but in the field it may be a ballpoint, bristles or for example two point discrimination. But the most important is be aware, test and follow-up!! As far as I can see Graded Sensory Testing is the standard.
I value the initiative of Dr Narasimha Rao, from Hyderabad, India (LML – August 5, 2013) as a step forward to overcome an unsatisfactory situation. Do not leave sensory testing exclusively to physio- (occupational) therapist, nurse or leprosy assistant; also the leprosy supervisor and medical doctor (including dermatologist) should assess nerve function (ST and VMT) routinely.
LML - S Deepak, B Naafs, S Noto and P Schreuder
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