Leprosy Mailing List – March 16 , 2014
Ref.: (LML) Effectiveness of sensory re-education in leprosy
From: Robert S. Jerskey, Carlsbad, California, USA
Dear Pieter,
I was pondering Mr. Karthikeyan's interesting request during the week. Thank you for the gentle nudge.
I have a few questions that might help me and perhaps other interested readers to get more than a glimpse of this particular patient population you are referring to, Karthikeyan:
1. I read that you mention a number of patients with this phenomenon. How many? Any remarkable information to share from their records/charts? Along with that, please state the criteria used for "recovery of touch", including which monofilament[s] and/or other instruments, and number and locale of sites on the hands tested.
2. Would you be able to describe/illustrate, more specifically, the nature of the "disturbed perception" you are referring to. That might be very helpful.
3. Are there any other sensory tests, besides monofilament testing, and any perceptual-motor tests which you have recruited that lead to your findings? They might also help shed some more light.
4. Finally, would you please cite the case report from Nigeria you mention, e.g., abstract from Pubmed if available, or your choice narrative of it.
I imagine that you have examined and ruled out such factors as co morbidities; and that considerations such as the following are not in the picture: socio-cultural perception of body image, or challenges of ambiguity of language [in this case: Hindi, as you are based in central U.P.] in some contexts that might allude to symptoms of, for example, purely sensory via peripheral nerve impairment vs. a higher cortical sourced impairment, e.g., from a CNS lesion.
I look forward to following your and other's responses on this particular LML trail, after which I may be more informed to address your initial question re: sensory re education. Thank you, Karthikeyan.
With warm greetings,
Robert
Robert S. Jerskey, LOTR, prevention of disability consultant
robjerskey@yahoo.com
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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