Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis

Pablo A. Baltodano; Danielle H. Rochlin; Jonathan Noboa; Karim A. Sarhane; Gedge D. Rosson; A. Lee Dellon

doi:10.1016/j.bjps.2016.03.013

Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis

Pablo A. Baltodano, Danielle H. Rochlin, Jonathan Noboa, Karim A. Sarhane, Gedge D. Rosson, A. Lee Dellon

Research output: Contribution to journal › Article › peer-review

5 Scopus citations

Abstract

The success of a microneurosurgical intervention in leprous neuropathy (LN) depends on the diagnosis of chronic compression before irreversible paralysis and digital loss occurs. In order to determine the effectiveness of a different approach for early identification of LN, neurosensory testing with the Pressure-Specified Sensory Device™ (PSSD), a validated and sensitive test, was performed in an endemic zone for leprosy. A cross-sectional study was conducted to analyze a patient sample meeting the World Health Organization (WHO) criteria for Hansen's disease. The prevalence of LN was based on the presence of ≥1 abnormal PSSD pressure threshold for a two-point static touch. A total of 312 upper and lower extremity nerves were evaluated in 39 patients. The PSSD found a 97.4% prevalence of LN. Tinel's sign was identified in 60% of these patients. An algorithm for early identification of patients with LN was proposed using PSSD testing based on the unilateral screening of the ulnar and deep peroneal nerves.

Original language	English (US)
Pages (from-to)	966-971
Number of pages	6
Journal	Journal of Plastic, Reconstructive and Aesthetic Surgery
Volume	69
Issue number	7
DOIs	https://doi.org/10.1016/j.bjps.2016.03.013
State	Published - Jul 1 2016
Externally published	Yes

Keywords

Leprosy
Nerve compression
Neurolysis
Neurosensory testing

ASJC Scopus subject areas

Surgery

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10.1016/j.bjps.2016.03.013

Cite this

Baltodano, P. A., Rochlin, D. H., Noboa, J., Sarhane, K. A., Rosson, G. D., & Dellon, A. L. (2016). Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis. Journal of Plastic, Reconstructive and Aesthetic Surgery, 69(7), 966-971. https://doi.org/10.1016/j.bjps.2016.03.013

Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis. / Baltodano, Pablo A.; Rochlin, Danielle H.; Noboa, Jonathan et al.
In: Journal of Plastic, Reconstructive and Aesthetic Surgery, Vol. 69, No. 7, 01.07.2016, p. 966-971.

Research output: Contribution to journal › Article › peer-review

Baltodano, PA, Rochlin, DH, Noboa, J, Sarhane, KA, Rosson, GD & Dellon, AL 2016, 'Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis', Journal of Plastic, Reconstructive and Aesthetic Surgery, vol. 69, no. 7, pp. 966-971. https://doi.org/10.1016/j.bjps.2016.03.013

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title = "Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis",

abstract = "The success of a microneurosurgical intervention in leprous neuropathy (LN) depends on the diagnosis of chronic compression before irreversible paralysis and digital loss occurs. In order to determine the effectiveness of a different approach for early identification of LN, neurosensory testing with the Pressure-Specified Sensory Device{\texttrademark} (PSSD), a validated and sensitive test, was performed in an endemic zone for leprosy. A cross-sectional study was conducted to analyze a patient sample meeting the World Health Organization (WHO) criteria for Hansen's disease. The prevalence of LN was based on the presence of ≥1 abnormal PSSD pressure threshold for a two-point static touch. A total of 312 upper and lower extremity nerves were evaluated in 39 patients. The PSSD found a 97.4% prevalence of LN. Tinel's sign was identified in 60% of these patients. An algorithm for early identification of patients with LN was proposed using PSSD testing based on the unilateral screening of the ulnar and deep peroneal nerves.",

keywords = "Leprosy, Nerve compression, Neurolysis, Neurosensory testing",

author = "Baltodano, {Pablo A.} and Rochlin, {Danielle H.} and Jonathan Noboa and Sarhane, {Karim A.} and Rosson, {Gedge D.} and Dellon, {A. Lee}",

note = "Funding Information: The Father Damien House of Guayaquil, Ecuador , provided funding for their staff in the care of the patients with leprosy, which included Mr Noboa. The Pressure-Specified Sensory Device was donated to the Father Damien House by A. Lee Dellon MD, PhD. A travel grant from the Dellon Foundation was given to Pablo A. Baltodano to visit Guayaquil, Ecuador. Dr Baltodano and Dr Sarhane conducted this study as part of their research under the direction of Gedge D. Rosson MD, in the Department of Plastic Surgery at Johns Hopkins University, from which their salaries were paid. Publisher Copyright: {\textcopyright} 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons.",

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AU - Dellon, A. Lee

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N2 - The success of a microneurosurgical intervention in leprous neuropathy (LN) depends on the diagnosis of chronic compression before irreversible paralysis and digital loss occurs. In order to determine the effectiveness of a different approach for early identification of LN, neurosensory testing with the Pressure-Specified Sensory Device™ (PSSD), a validated and sensitive test, was performed in an endemic zone for leprosy. A cross-sectional study was conducted to analyze a patient sample meeting the World Health Organization (WHO) criteria for Hansen's disease. The prevalence of LN was based on the presence of ≥1 abnormal PSSD pressure threshold for a two-point static touch. A total of 312 upper and lower extremity nerves were evaluated in 39 patients. The PSSD found a 97.4% prevalence of LN. Tinel's sign was identified in 60% of these patients. An algorithm for early identification of patients with LN was proposed using PSSD testing based on the unilateral screening of the ulnar and deep peroneal nerves.

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Prevalence of leprous neuropathy determined by neurosensory testing in an endemic zone in Ecuador: Development of an algorithm to identify patients benefiting from early neurolysis

Abstract

Keywords

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