Leprosy Mailing List – August 13, 2013
Ref.: (LML) Sensory testing peripheral neuropathy
From: Grace Warren, Sidney, Australia
Dear Pieter,
I note a few letters in the last 24 hours, regarding recording of abnormalities in sensory perception .
I wonder if you have ever seen my text book" The care of Neuropathic limbs" that Prof Syd Nade ( orthopaedic surgeon) helped me get published in 1999. In it there is a lovely little cartoon showing the use of a open oval paper clip that is almost better than a pen as when the clip is part opened one has a blunt curved end and a flat cut end and one can make the patient point to where he feels the touch and say smooth or rough. Often the patient can feel touch , all be it vaguely- but cannot tell whether it is sharp or blunt so has an abnormality of sensory perception or he has misreference and points to the wrong spot. So here are two other methods of charting sensory abnormality in a patient who says Yes I can feel - but does not have a supply of the good filaments. I have managed to scan the illustration on to this email so it is there if you feel it worth including (see attached file).
For those who receive it "Tropical doctor" published an article by me on October 2002, called " Practical Management of neuropathic feet" in which we included the cartoon., and some other relevant facts and diagrams about care of neuropathic limbs.
Good testing!! Grace.
p/s By the way my text book " the care of neuropathic limbs " is no longer available from the publisher( who closed down) but I still have a few hundred copies that I will gladly give to those who are really prepared to use it., When it was first published in 1999 the Leprosy Mission ordered an extra 500 laminated copies that we gave to leprosy hospitals and clinics round the world., But I suspect I have the only remaining store now , and am trying to place them where they will be used properly, instead of being recycled and destroyed.,
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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