Leprosy Mailing List – February 8, 2017
Ref.: (LML) Silent neuritis. Nerve damage. Disability and deformity. Prevention and management.
From: José Antonio Garbino, Bauru, Brazil
Dear Pieter and all,
Excellent article from Linda (LML, February 5, 2017)! I think that this algorithm called LOFT is the basis of the nerve function follow up, and that it should be always be remembered. SORRI and ILSL developed a Software called NervScore that transforms the serial NFI evaluations and medication doses in graphs making possible to see easily the evolution of all nerves under the treatment: http://www.sorribauru.com.br/ email: ti@sorribauru.com.br. Attached is a paper about nerve evaluation and a PP about the NervScore.
On the other hand, in what the more armed technology may help?
Well, we have both in current use: the nerve conduction studies (NCS) and the nerve ultrasound (US).
- The NCS can add the understanding of the NFI underline neuropathology – demyelination acute or subacute that means nerve inflammation-, it can show the sites of entrapment precisely, the severity more accurately and based in these findings one can presume the prognosis.
- The US is more useful to show nerve morphology, i.e. the enlargement, nerve abscess, liquid collection in the nerve abscess or not. The US with Doppler can also show nerve inflammation. The Doppler, in my point of view, can be useful to show inflammation when the NCS doesn´t show demyelination, when the picture is only axonal.
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Which gains the approach to the underline neuropathology will provide to the NFI follow up? These data will serve as the guideline for the steroid or other immunosuppressant treatment, and will also show if it is working effectively.
Best regards,
Garbino
Jose Antonio Garbino, MD, PhD, Clinical Neurophysiology
Research Institute "Lauro de Souza Lima', Bauru/SP
- José Antonio Garbino, MD, PhDa,⁎, Carlos Otto Heise, MD, PhDb,
Wilson Marques Jr., MD, PhDc. Assessing nerves in leprosy. Clinics in Dermatology (2015)
- Garbino JA, Bento LFM, Marques T, Quaggio CMP, Nardi SMT, Nicholl ARJ, Bentim C, Virmond M. Software for Assessing Nerves. ILSL, Bauru, São Paulo, Brazil
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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