[Randomized controlled trial of medical and medico-surgical treatment of Hansen's neuritis]. / Essai comparé randomisé du traitement médical et médico-chirurgical des névrites hanséniennes.

The aim of the study was to compare the results of the medical treatment alone and of the medico-surgical treatment on leprous neuritis. The patients were followed-up during 2 years, with regular neurological evaluations. The statistical study was performed using the Tukey test. Ninety-three nerves (ulnar, median, common peroneal and posterior tibial) with a deficit of less than 6 months duration have been studied in 31 leprosy patients. All the patients were treated by steroids but in some of them a nerve surgical decompression was performed. An improvement of the sensitive and motor deficit was observed in both groups. No significant statistical differences appeared between the 2 groups according to the nerve involved, the duration of the deficit, the form of leprosy and the type of antibacillary treatment. However, the medico-surgical treatment had a significant better result on pain and on major but incomplete nervous involvement. This study included a limited number of nerves, thus, it would be useful to perform others randomized assays to better define the indications of surgical decompression in the management of leprous neuritis.

[Lepromatous leprosy: clinical and electrophysiological arguments in favor of axonal multi-neuritis]. / Lèpre lépromateuse: arguments cliniques et électrophysiologiques en faveur d'une multinévrite axonale.

UNLABELLED: This work was undertaken because there were only few reports on neurological aspects on lepromatous leprosy. We studied 30 patients suffering from lepromatous leprosy who, at their first visit to the Institute had never been treated. The clinical examination included a quantitative evaluation of the neurological status following the method developed by Pearson. Motor and sensory nerve conduction velocities were measured: values of conduction velocity and distal amplitude were analysed and compared to those of a group of 22 healthy subjects. IN CONCLUSION: (a) There is a high frequency of clinical and especially electrophysiological neurological impairment. This impairment can be extremely precocious and may happen shortly after the first cutaneous signs. (b) Nervous impairment is diffuse, bilateral but not homogeneous. These are characteristics of mononeuritis multiplex. Impairement is predominantly sensitive and tactile sensibility is more involved than thermo-algic sensation. (c) The radial superficial nerve is the most frequently involved clinically and electrophysiologically. (d) The electrophysiological results, showing a normal or slightly reduced conduction velocity and a low amplitude of evoked potentiel are in favour of a predominantly axonal damage.