FW: (LML) d.d. pure neuritic leprosy and diabetic neuropathy

 

 

Leprosy Mailing List – February 16,  2021

 

Ref.:  (LML) d.d. pure neuritic leprosy and diabetic neuropathy

 

From:  Wim van Brakel, Amsterdam, the Netherlands

 

Dear Pieter,

I agree with the points raised by Wim Theuvenet (LML, February 14, 2021).

One other addition from my days of research sensory impairment and sensory in leprosy. Sensory impairment in diabetes tends to be 'deep'. I.e., it also impairs 'deep' sensibility such as vibration sense when tested with a tuning fork or vibrameter on a bony prominence like the ankle. In leprosy, this was rarely impaired.

We did find impaired vibration sense in soft tissue like the finger pulp or toe pulp in a minority of patients (Van Brakel et al, Leprosy Review 1994; Van Brakel et al, PLoS NTD 2008), but most of these patients still felt vibration through bone conduction. Although not likely to be fool proof, this may be a quick way to distinguish the two neuropathies in patients who have bilateral sensory impairment.

 

Kind regards,

Wim van Brakel

Medical Director NLR

 

Wim van Brakel

Medical Director

W.vanBrakel@nlrinternational.org

 

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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