Fw: Ref.: (LML) Median nerve damage in leprosy

 

 
Leprosy Mailing List – January 12,  2022

 

Ref.:  (LML) Median nerve damage in leprosy

 

From:  Laila de Laquiche, Curitiba, Brazil

 

Dear Pieter,

I thank Dr. Grauwin for his contribution to our discussion on nerve damage (January 10 - LML) which masterfully explained details of upper limb neuritis: Ulnar and Median Nerve, in addition to indications for nerve decompression and treatment. Acting in African territory certainly brings the necessary difference for quality medical care in that region, which I particularly appreciate this effort.

The question I raised is what would be the correct therapeutic approach, since this case under discussion (Dr. Noto - Italia 07 January LML) was diagnosed and treated with a Paucibacillary regimen for 6 months. 

 

Paraesthesia was accidentally diagnosed at the end of treatment due to an accidental injury to the fingers. We do not have data on which initial lesions corroborated this clinical classification and if there was an initial analysis of the sensory and motor function of that limb or even if there was a suspicion of neural damage. But if there were, it would already be indicative of MB treatment according to the WHO guidelines.

The biggest question is: what is the desired therapeutic approach: to face neuritis as an immunological reaction or as a continuation of the neural injury directly caused by the bacillus lodged in the nerve sheaths?

I don't have that answer, but I would certainly like to fully treat patients who suffer from an infectious-immunological disease, at least as far as the infectious part is concerned. Both approaches are not mutually exclusive and we can continue to seek our gold standard in the management of these patients.

Sincerely,

 

Laila de LAGUICHE

Curitiba - Paraná

 

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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