Leprosy Mailing List – August 19, 2013
Ref.: (LML) SW monofilaments
From: Ben Naafs, Munnekeburen, the Netherlands
Dear Pieter,
I’m very pleased with the interest shown in sensory testing in leprosy. I would like to present a summary of the history of graded sensory testing with monofilaments. Everybody speaks of the Semmes-Weinstein monofilaments, though if I could choose I would preferably attribute the monofilaments to other persons.
It was Von Frey in the 19th century who was the first one to use graded bristle testing. He used horse hairs. The first who used graded monofilaments consequently was as far as I know Weddell in the 40th and 50th. The first ones to use it in leprosy were students of his, Jamison (in the 70th) who used it in maculae and Pearson (again in the 70TH) who introduced it in the follow up and diagnosis of reactions. He worked closely together with a physiotherapist, Jean Watson. Naafs was the first one to describe its use in the follow-up of neuropathy (70th) and in the follow-up of patients in the 80th . It was Judith Bell-Krotoski who really advocated it and made it popular. Later this was taken over in Brazil by Garbino as doctor and Linda Lehman as physiotherapist. Where Weddell used the monofilaments already in the 40th and 50th Semmes and Weinstein started its use in the 60th and 70th .
There is a difference in use by Pearson, Watson and Naafs and later on by physiotherapist and revalidation specialists who took over the interest in the use of monofilaments. The former, for the hand used the graded bristles on the thenar and hypothenar only, to assess the function of median and ulnar nerves, avoiding maculae in those areas. Since Bell-Krotoski the whole hand was mapped, like later Semmes and Weinstein did for the foot. Such use is more tedious and gives mixed information, not only on the nerve trunks but about small nerves in the fingers and palm as well.
With many greetings,
Ben
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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