Leprosy Mailing List – November 18, 2016
Ref.: (LML) I was dreaming
From: Ben Naafs, Munnekeburen, the Netherlands
Dear LML reader,
We received a question for Ben Naafs from Jim Wilton, NH, USA:
“Ben, at the known areas of construction where the primary damage occurs we perform epineural decompressions. We have had excellent surgical results working in South America over the past 15 years seeing results in increasing motor power, decreasing or eliminating peripheral nerve pain, and restoring function to arms and legs.”
Reaction Dr Naafs:
“Thank you for your comments.
I agree with you. Nerve surgery, epineural decompression, is a sensible additive to immune-decompression and MDT. But to think in sequence: first diagnose, then start antibacterial treatment. Then try to work anti-inflammatory and immunosuppressive. Only when the nerve is still compressed and deteriorate a month to 3 month after initiating strong (prednisone) anti-inflammatory therapy, than a nerve decompression should be done. In my theory that is also needed. In my experience too. But surgery should be an addition and not the primary treatment.
What I described, is what will happen untreated. Prednisolone and surgery will take away the compression. But what about MAC and LAM particular in MB that can be present a long time, even under proper antibacterial treatment?”
Ben Naafs
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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