Evaluation of sensibility in leprosy--comparison of various clinical methods. 1994

W H van Brakel, and J Shute, and J A Dixon, and H Arzet
Green Pastures Hospital, Pokhara, Nepal.

In order to determine whether various sensibility tests, not in common use at our hospital, are appropriate for the neurological screening of leprosy patients, an extended nerve function assessment (NFA) was done on 50 in- and outpatients who had been diagnosed as suffering from leprosy (100 hands and feet). The nerve function assessment battery consisted of Semmes-Weinstein monofilament testing (SWMT), moving 2-point discrimination (M2PD). Pinprick (PP), position sense (PS), vibration sense (VS) and voluntary muscle testing (VMT). In addition the SWMT was performed on 637 hands and 634 feet of field patients' in order to get a better indication of the prevalence of sensory impairment as measured with the SWMT. The SWMT has been shown to be a sensitive test of peripheral nerve function, therefore the other tests were compared with the SWMT. Results are reported separately for the ulnar, median and posterior tibial nerve. Test sites were the pulp of the distal phalanx of the index finger, the little finger and the big toe. Correlation between the SWMT and each of the other tests proved statistically significant; the closest correlations were between the SWMT, M2PD and PP for both ulnar and median nerves (r > 0.7, F test > 100, p < 0.0001). It is argued that the first tests to show nerve function impairment (NFI) are the M2PD and the SWMT. VS and PS were also absent in a significant proportion of patients. Arguments are presented that this may indicate advanced NFI. Results are compared with other data currently available in the literature.

UI MeSH Term Description Entries
D007918 Leprosy A chronic granulomatous infection caused by MYCOBACTERIUM LEPRAE. The granulomatous lesions are manifested in the skin, the mucous membranes, and the peripheral nerves. Two polar or principal types are lepromatous and tuberculoid. Hansen's Disease,Hansen Disease
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009460 Neurologic Examination Assessment of sensory and motor responses and reflexes that is used to determine impairment of the nervous system. Examination, Neurologic,Neurological Examination,Examination, Neurological,Examinations, Neurologic,Examinations, Neurological,Neurologic Examinations,Neurological Examinations
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D012677 Sensation The process in which specialized SENSORY RECEPTOR CELLS transduce peripheral stimuli (physical or chemical) into NERVE IMPULSES which are then transmitted to the various sensory centers in the CENTRAL NERVOUS SYSTEM. Sensory Function,Organoleptic,Function, Sensory,Functions, Sensory,Sensations,Sensory Functions

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