Baltodano Pablo A, Rochlin Danielle H, Noboa Jonathan, Sarhane Karim A, Rosson Gedge D, Dellon A Lee
The Dellon Institutes for Peripheral Nerve Surgery, Towson, MD, USA.
Damien House Organization, Guayaquil, Ecuador.
J Plast Reconstr Aesthet Surg. 2016 Jul;69(7):966-71. doi: 10.1016/j.bjps.2016.03.013. Epub 2016 Apr 7.
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.
麻风性神经病（LN）显微神经外科手术干预的成功取决于在不可逆性麻痹和手指丧失发生之前对慢性压迫的诊断。为了确定一种不同方法对早期识别LN的有效性，在麻风病流行地区使用压力特定感觉装置（PSSD）进行了神经感觉测试，这是一种经过验证且敏感的测试。开展了一项横断面研究，以分析符合世界卫生组织（WHO）麻风病标准的患者样本。LN的患病率基于两点静态触觉的PSSD压力阈值≥1个异常来确定。对39例患者的总共312条上肢和下肢神经进行了评估。PSSD发现LN的患病率为97.4%。这些患者中有60%出现了Tinel征。基于对尺神经和腓深神经的单侧筛查，提出了一种使用PSSD测试早期识别LN患者的算法。
