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Initial neurological exam of multibacillary leprosy: correlation between the presence of affected nerves and disability present at diagnosis and with the occurrence of overt neuritis

BACKGROUND: Disabilities constitute the main problem of leprosy. It is important to identify risk factors involved, so it can be possible the prone patients be followed-up more carefully. OBJECTIVES: To determine if the presence of thick and/or painful peripheral nerves at diagnosis correlates with disabilities already present at the initial examination, as well as with subsequent development of neuritis, during and after multidrug therapy. METHODS: One hundred and three patients with multibacillary forms of leprosy were studied, and we noted the presence of compromised peripheral nerves at diagnosis, the disability grade before treatment (DGBT), and the occurrence of neuritis episodes during and after multibacillary multidrug therapy. RESULTS: The detection of affected peripheral nerves at diagnosis correlated statistically (p < 0.005) with the occurrence of disabilities (DGBT > 0). It also correlated significantly with the development of neuritis in the follow-up (average of 64.6 months from diagnosis, during and after multidrug therapy). CONCLUSIONS: We emphasize the need of a good examination of peripheral nerve trunks in multibacillary patients at the diagnosis, in order to improve the detection of disabilities already present, and specially to prevent further disabilities. Healthy professionals who deal with leprosy patients must be aware to the inicial neurological impairments because those patients are more susceptible to the occurrence of neuritis and neurological sequelae.

statistics on sequelae and disability; leprosy; peripheral nerves; neuritis


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