1921
Volume 98, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

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.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.17-0817
2018-04-02
2019-05-23
Loading full text...

Full text loading...

/deliver/fulltext/14761645/98/6/tpmd170817.html?itemId=/content/journals/10.4269/ajtmh.17-0817&mimeType=html&fmt=ahah

References

  1. Rodrigues LC, Lockwood DNj, , 2011. Leprosy now: epidemiology, progress, challenges, and research gaps. Lancet Infect Dis 11: 464470. [Google Scholar]
  2. Finnerup NB, 2016. Neuropathic pain: an updated grading system for research and clinical practice. Pain 157: 15991606. [Google Scholar]
  3. Haanpää M, Lockwood DN, Hietaharju A, , 2004. Neuropathic pain in leprosy. Lepr Rev 75: 718. [Google Scholar]
  4. Merskey H, Bogduk N, , 1994. Classification of Chronic Pain, IASP Task Force on Taxonomy, 2nd edition. Seattle, WA: IASP Press.
  5. Garbino JA, 2011. Association between neuropathic pain and A-waves in leprosy patients with type 1 and 2 reactions. J Clin Neurophysiol 28: 329332. [Google Scholar]
  6. Van Veen NH, Nicholls PG, Smith WC, Richardus JH, , 2016. Corticosteroids for treating nerve damage in leprosy. Cochrane Database Syst Rev 23: CD005491. [Google Scholar]
  7. Santos JG, 2010. Translation to Portuguese and validation of the Douleur Neuropathique 4 Questionnaire. J Pain 5: 484490. [Google Scholar]
  8. Hamilton M, , 1960. A rating scale for depression. J Neurol Neurosurg Psychiatry 23: 5662. [Google Scholar]
  9. Henrique-Araújo R, 2014. Transcultural adaptation of GRID Hamilton rating scale for depression (GRID-HAMD) to Brazilian Portuguese and evaluation of the impact of training upon inter-rater reliability. Innov Clin Neurosci 11: 1018. [Google Scholar]
  10. Zimmerman M, Martinez JH, Young D, Chelminski I, Dalrymple K, , 2013. Severity classification on the Hamilton depression rating scale. J Affect Disord 150: 384388. [Google Scholar]
  11. SORRI, 2008. Monofilament Aesthesiometer: Touch Sensitivity Testing Kit, User’s manual. São Paulo, Brazil: SORRI-Bauru.
  12. Camargo LHS, Baccarelli R, , 1997. Avaliação sensitiva na neuropatia hansênica. Duerksen F, Virmond M, eds. Cirurgia reparadora e reabilitação em hanseníase. Bauru, Brazil: Centro de estudos Dr. Reynaldo Quagliato, Instituto Lauro de Souza Lima, 75–83.
  13. Compston A, , 2010. Aids to the investigation of peripheral nerve injuries. Medical Research Council: Nerve Injuries Research Committee. His Majesty’s Stationery Office: 1942; pp. 48 (iii) and 74 figures and 7 diagrams; with aids to the examination of the peripheral nervous system. By Michael O’Brien for the Guarantors of Brain. Saunders Elsevier: 2010; pp. [8] 64 and 94 Figures. Brain 133: 28382844. [Google Scholar]
  14. World Health Organization, 1988. WHO Expert Committee on Leprosy, Sixth Report. Geneva, Switzerland: WHO.
  15. Delisa JA, 1994. Manual of Nerve Conduction Velocity and Clinical Neurophysiology. Philadelphia, PA: Lippincott Williams & Wilkins.
  16. Haroun OM, 2012. Investigation of neuropathic pain in treated leprosy patients in Ethiopia: a cross-sectional study. Pain 153: 16201624. [Google Scholar]
  17. Ramos JM, 2014. Prevalence and characteristics of neuropathic pain in leprosy patients treated years ago. Pathog Glob Health 108: 186190. [Google Scholar]
  18. Lasry-Levy E, 2011. Neuropathic pain and psychological morbidity in patients with treated leprosy: a cross-sectional prevalence study in Mumbai. PLoS Negl Trop Dis 5: 18. [Google Scholar]
  19. Raicher I, 2016. Neuropathic pain in leprosy. Clin Dermatol 34: 5965. [Google Scholar]
  20. Chen S, Qu J, Chu T, , 2012. Prevalence and characteristics of neuropathic pain in the people affected by leprosy in China. Lepr Rev 83: 195201. [Google Scholar]
  21. Hietaharju A, 2000. Chronic neuropathic pain in treated leprosy. Lancet 23: 10801081. [Google Scholar]
  22. Saunderson PR, Bizuneh E, Leekassa R, , 2008. Neuropathic pain in people treated for multibacillary leprosy more than ten years previously. Lepr Rev 79: 270276. [Google Scholar]
  23. Stump PR, 2004. Neuropathic pain in leprosy patients. Int J Lepr Other Mycobact Dis 72: 134138. [Google Scholar]
  24. Greenspan JD, 2007. Consensus working group of the sex, gender, and pain SIG of the IASP. Studying sex and gender differences in pain and analgesia: a consensus report. Pain 132: S26S45. [Google Scholar]
  25. Isacson D, Bingefors K, , 2002. Epidemiology of analgesic use: a gender perspective. Eur J Anaesthesiol Suppl 26: 515. [Google Scholar]
  26. Reibel F, Cambau E, Aubry A, , 2015. Update on the epidemiology, diagnosis, and treatment of leprosy. Med Mal Infect 45: 383393. [Google Scholar]
  27. Baron R, 2009. A cross-sectional cohort survey in 2100 patients with painful diabetic neuropathy and postherpetic neuralgia: differences in demographic data and sensory symptoms. Pain 146: 3440. [Google Scholar]
  28. Bennett MI, Smith BH, Torrance N, Lee AJ, , 2006. Can pain be more or less neuropathic? Comparison of symptom assessment tools with ratings of certainty by clinicians. Pain 122: 289294. [Google Scholar]
  29. Lund C, 2007. Histopathological and clinical findings in leprosy patients with chronic neuropathic pain: a study from Hyderabad, India. Lepr Rev 78: 369380. [Google Scholar]
  30. Jardim MR, 2003. Criteria for diagnosis of pure neural leprosy. J Neurol 250: 806809. [Google Scholar]
  31. Solomon S, Kurian N, Ramadas P, Rao PS, , 1998. Incidence of nerve damage in leprosy patients treated with MDT. Int J Lepr Other Mycobact Dis 66: 451456. [Google Scholar]
  32. Khambati FA, Shetty VP, Ghate SD, Capadia GD, , 2009. Sensitivity and specificity of nerve palpation, monofilament testing and voluntary muscle testing in detecting peripheral nerve abnormality, using nerve conduction studies as gold standard; a study in 357 patients. Lepr Rev 80: 3450. [Google Scholar]
  33. Rambukkana A, , 2000. How does Mycobacterium leprae target the peripheral nervous system? Trends Microbiol 8: 2328. [Google Scholar]
  34. Vital RT, 2012. Progression of leprosy neuropathy: a case series study. Brain Behav 2: 249255. [Google Scholar]
  35. Freeman RL, , 2009. Painful peripheral neuropathy: diagnosis and assessment. Continuum. Lifelong Learning in Neurology 15: 1329. [Google Scholar]
  36. Haanpää M, 2011. NeuPSIG guidelines on neuropathic pain assessment. Pain 152: 1427. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.17-0817
Loading
/content/journals/10.4269/ajtmh.17-0817
Loading

Data & Media loading...

  • Received : 19 Oct 2017
  • Accepted : 27 Dec 2017
  • Published online : 02 Apr 2018

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error