Leprosy
mailing list – November 25th, 2005
Ccn: all.
From:
E Pearl Penumaka, Martinez, CA, USA.
Dear Dr. Warren,
I do agree with what you have expressed regarding
the LL case and BT cases (LML, Nov. 19th, 2005). When I
worked with Dr S. Arunthathi in Schieffelin Leprosy Center she
encouraged us to identify high risk cases. Those patients with
enlarged nerves and not in any obvious pain or tenderness or without
loss of any nerve function were classified as high risk cases.
These cases were monitored every week or sometimes depending on how
big the nerve is enlarged, we treated them with steroids so that the
inflammation reduced before it caused any damage.
In the leprosy control project in Bangalore where I
worked I had a very good volunteer physiotherapist Ms. Lekha Rai who
would help me identify the patients with early loss of sensation or
motor function. Sometimes patients with enlarged nerves but no
clinical symptoms were treated with steroids. Our aim was to prevent
disabilities. These patients were monitored frequently to assess the
response or any deterioration.
This helped in patients with BT-BB cases and I do
agree it is difficult to do that in LL cases as they already have
glove and stocking anaesthesia or the nerves are damaged during ENL
reactions.
I also agree there is a definite need to understand
and study the neuropathy in LL cases and its prevention. I am hoping to study on the
incidence of silent neuritis in a particular time period. I would be happy if you can
also refer me some articles on this topic for me to study.
Thanking you once again.
Sincerely,
Elizabeth
