Post-graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
Am J Trop Med Hyg. 2018 Jun;98(6):1609-1613. doi: 10.4269/ajtmh.17-0817. Epub 2018 Mar 29.
Neural pain is a frequent symptom in leprosy disease. There is a paucity of data regarding neural pain diagnostics resulting in common prescriptive errors when neuritis is confused with neuropathic or mixed nociceptive-neuropathic pain. The present study identified important demographic, clinical, and neurophysiological features of 42 leprosy neuropathy patients presenting neuropathic pain (NP). During routine evaluations, patients were selected asking if they had ever experienced neural pain. Data analyses of their pain characteristics, clinical examination results, and both the Douleur Neuropathique 4 Questionnaire and Hamilton Depression Scale scores were used to classify these patients. The most common word they used to describe the sensation of pain for 25 (60%) of these patients was "burning." In the early stages of the disease and before leprosy diagnosis, 19 (45%) had already complained about NP and leprosy treatment was unable to prevent its occurrence in 15 (36%). Leprosy reactions, considered NP risk factors, occurred in 32 (76%) cases. Knowledge of typical NP characteristics could be used to develop more effective therapeutic approaches for a notoriously difficult-to-treat pain condition.
神经痛是麻风病的常见症状。由于神经炎与神经病理性或混合性伤害感受神经痛容易混淆,因此神经痛的诊断数据很少,导致常见的处方错误。本研究确定了 42 例表现为神经病理性疼痛(NP)的麻风性神经病患者的重要人口统计学、临床和神经生理学特征。在常规评估中,询问患者是否曾经历过神经痛来选择患者。分析他们的疼痛特征、临床检查结果以及疼痛性神经病 4 项问卷和汉密尔顿抑郁量表评分,以对这些患者进行分类。其中 25 名患者(60%)最常用的描述疼痛感觉的词是“灼热”。在疾病的早期阶段和麻风病诊断之前,有 19 名患者(45%)已经抱怨过 NP,而 15 名患者(36%)的麻风病治疗无法预防其发生。被认为是 NP 危险因素的麻风反应发生在 32 例(76%)患者中。了解典型的 NP 特征可以用于开发更有效的治疗方法,因为这种疼痛状况很难治疗。