RESUMO
Apresenta dados da Hanseníase no Brasil no Mundo. Apresenta avaliação das Lesões dos nervos periféricos, na região nasal, olhos, Nervo Facial, Nervo Trigêmeo, Teste de Acuidade Visual, Nervo Auricular, Nervo Ulnar, Nervo Mediano, Nervo Radial e Radial Cutâneo, Técnica do Estesiômetro, Nervo Fibular Profundo e Superficial, Nervo Tibial Posterior, Estesiometria nos pés.
It presents data on Hansen's disease in Brazil worldwide. Presents evaluation of peripheral nerve injuries, in the nasal region, eyes, facial nerve, trigeminal nerve, visual acuity test, auricular nerve, ulnar nerve, median nerve, radial and radial cutaneous nerve, esthesiometer technique, deep and superficial fibular nerve, Posterior Tibial Nerve, Stoichiometry in the feet.
Presenta datos sobre la enfermedad de Hansen en Brasil en todo el mundo. Presenta evaluación de lesiones de nervios periféricos, en la región nasal, ojos, nervio facial, nervio trigémino, prueba de agudeza visual, nervio auricular, nervio cubital, nervio mediano, nervio cutáneo radial y radial, técnica de estesiómetro, nervio peroneo profundo y superficial, Nervio Tibial Posterior, Estequiometria en los pies.
Il présente des données sur la maladie de Hansen au Brésil dans le monde entier. Présente l'évaluation des lésions nerveuses périphériques, dans la région nasale, les yeux, le nerf facial, le nerf trijumeau, le test d'acuité visuelle, le nerf auriculaire, le nerf ulnaire, le nerf médian, le nerf cutané radial et radial, la technique de l'esthésiomètre, le nerf fibulaire profond et superficiel, Nerf tibial postérieur, stoechiométrie dans les pieds.
Assuntos
Humanos , Hansenostáticos , Hanseníase/complicações , Hanseníase/diagnóstico , Nervo Trigêmeo/anormalidades , Esclerite/diagnóstico , Ectrópio/diagnóstico , Nervo Facial/anatomia & histologia , Triquíase/fisiopatologiaRESUMO
OBJECTIVES: To determine whether the measured change in score of a validated clinical severity scale reflected physician assessed improvement in individuals who had received corticosteroid therapy for leprosy associated nerve damage. DESIGN: Patients with nerve function impairment who participated in a randomised controlled trial of corticosteroids were classified into two groups using a retrospectively determined physician assessment of improvement. One group consisted of patients who had recovered or improved the other of patients who were unchanged or had deteriorated. The change in the clinical severity scale scores of these two groups was compared. RESULTS: The change in the clinical severity scale scores of the 34 eligible individuals in the two groups were significantly different (P = 0.003). Individuals in the group who recovered or improved had a greater change in severity score than those whose nerve function was unchanged or deteriorated. CONCLUSION: The scale for measuring the severity of leprosy Type 1 reactions (T1Rs) and/or nerve function impairment reflects the clinical improvement of individuals with leprosy associated nerve damage.
Assuntos
Hanseníase/complicações , Metilprednisolona/uso terapêutico , Doenças do Sistema Nervoso/tratamento farmacológico , Doenças do Sistema Nervoso/fisiopatologia , Índice de Gravidade de Doença , Adolescente , Adulto , Idoso , Feminino , Humanos , Hanseníase/fisiopatologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia , Doenças do Sistema Nervoso/etiologia , Exame Neurológico , Fármacos Neuroprotetores/uso terapêutico , Prednisolona/uso terapêutico , Nervo Tibial/fisiopatologia , Nervo Trigêmeo/fisiopatologia , Adulto JovemRESUMO
An example of trigeminal trophic syndrome presenting as ulceration of ala nasi in a case of borderline tuberculoid leprosy is reported. To the best of our knowledge, this is only the second case report of this manifestation in leprosy to be documented.
Assuntos
Hanseníase Dimorfa/complicações , Hanseníase Tuberculoide/complicações , Úlcera Cutânea/tratamento farmacológico , Doenças do Nervo Trigêmeo/tratamento farmacológico , Biópsia , Humanos , Hanseníase Dimorfa/tratamento farmacológico , Hanseníase Tuberculoide/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Nariz/patologia , Úlcera Cutânea/complicações , Síndrome , Resultado do Tratamento , Nervo Trigêmeo/patologia , Doenças do Nervo Trigêmeo/complicaçõesRESUMO
Involvement of cranial nerves is not uncommon in leprosy with trigeminal and facial nerves being commonly affected. Other cranial nerves can also be involved especially in longstanding cases of leprosy towards the lepromatous pole. Herein, we report a case of leprosy with multiple cranial neuropathy mimicking Melkerson Rosenthal syndrome.
Assuntos
Doenças dos Nervos Cranianos/etiologia , Doenças dos Nervos Cranianos/fisiopatologia , Hanseníase/complicações , Hanseníase/diagnóstico , Síndrome de Melkersson-Rosenthal/diagnóstico , Adulto , Idoso , Antituberculosos/uso terapêutico , Doenças dos Nervos Cranianos/tratamento farmacológico , Doenças dos Nervos Cranianos/patologia , Diagnóstico Diferencial , Nervo Facial/fisiopatologia , Nervo Glossofaríngeo/fisiopatologia , Humanos , Hanseníase/classificação , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Nervo Trigêmeo/fisiopatologiaRESUMO
BACKGROUND: Leprosy is one of the most common causes of peripheral neuropathy, perhaps closely matched by diabetic neuropathy. Patterns of peripheral neuropathy in leprosy can be varied, which may include mononeuropathy, mononeuritis multiplex and symmetric polyneuropathy. Cranial nerves, especially facial and trigeminal nerves, are also commonly involved in leprosy. AIMS: To find out the pattern and spectrum of cranial nerve involvement in a consecutive series of patients with leprous neuropathy. SETTINGS AND DESIGN: A retrospective review of patients admitted with leprosy to the Neurology Department of a tertiary care center. MATERIALS AND METHODS: All consecutive patients admitted during an 8-year period (1995-2003) and diagnosed to have leprosy were included. They were clinically evaluated to determine the frequency and pattern of cranial nerve involvement. RESULTS: About 18% (9/51) of the leprosy patients seen during that period had clinical evidence of cranial nerve involvement. Facial and trigeminal nerves were the most commonly affected (five and four patients respectively). CONCLUSIONS: Cranial nerve involvement is common in leprosy, which emphasizes the need to carefully examine them. Also, one should exclude leprosy in patients presenting with isolated cranial neuropathies.
Assuntos
Doenças dos Nervos Cranianos/etiologia , Doenças dos Nervos Cranianos/patologia , Nervo Facial/patologia , Hanseníase/complicações , Hanseníase/patologia , Nervo Trigêmeo/patologia , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Pele/patologiaRESUMO
The trigeminal and great auricular nerves which supply sensation to the face are affected in leprosy. No objective sensory testing methods have been devised for testing sensation in the face. Testing for corneal sensation to ascertain trigeminal nerve or visualization and palpation of the great auricular nerve alone may not be enough to establish the involvement of these nerves. In a sample of leprosy patients, face sensation threshold measurements were done using a set of three Semmes-Weinstein (SW) monofilaments that gave a force of 0.05-0.07, 0.2 and 2 g. Sensation was tested by three examiners and intra- and inter-observer testing was used as a means to validate the findings. Within the limitations of this study, the results indicate that use of SW monofilaments is a fairly reliable and repeatable method for sensory testing in the face. During follow up, a single filament with a force of 0.5-0.7 g (2.83 marking number in SW filament or any other filament with a corresponding gram force) could be used to assess sensation. A simple procedure of quantifying sensation in these nerves is suggested. A method to incorporate trigeminal or great auricular nerve sensory testing into the existing sensory assessment charts is also discussed.
Assuntos
Hanseníase/complicações , Hanseníase/fisiopatologia , Nervo Trigêmeo/fisiopatologiaRESUMO
The trigeminal and great auricular nerves which supply sensation to the face are affected in leprosy. No objective sensory testing methods have been devised for testing sensation in the face. Testing for corneal sensation to ascertain trigeminal nerve or visualization and palpation of the great auricular nerve alone may not be enough to establish the involvement of these nerves. In a sample of leprosy patients, face sensation threshold measurements were done using a set of three Semmes-Weinstein (SW) monofilaments that gave a force of 0.05-0.07, 0.2 and 2 g. Sensation was tested by three examiners and intra- and inter-observer testing was used as a means to validate the findings. Within the limitations of this study, the results indicate that use of SW monofilaments is a fairly reliable and repeatable method for sensory testing in the face. During follow up, a single filament with a force of 0.5-0.7 g (2.83 marking number in SW filament or any other filament with a corresponding gram force) could be used to assess sensation. A simple procedure of quantifying sensation in these nerves is suggested. A method to incorporate trigeminal or great auricular nerve sensory testing into the existing sensory assessment charts is also discussed.
Assuntos
Face/inervação , Hipestesia/diagnóstico , Hanseníase/fisiopatologia , Nervo Trigêmeo/fisiopatologia , Face/fisiopatologia , Feminino , Humanos , Hipestesia/etiologia , Hanseníase/complicações , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos TestesAssuntos
Doenças do Nervo Facial , Nervo Fibular , Nervo Mediano , Nervo Radial , Nervo Tibial , Nervo Trigêmeo , Nervo UlnarRESUMO
Thirty-nine patients with leprosy and fifteen sex- and age-matched controls were investigated for disorders of the fifth and seventh cranial nerves and that of the audiovestibular system. Sensorineural hearing loss found to be of cochlear origin was detected in eight (22%) of the patients with leprosy compared to none in the control group (p > 0.05). Vestibular dysfunction was noted in four patients (11.1%) compared to none in the control group (p < or = 0.05). Two cases were found to have fifth nerve involvement and one (2.8%) had seventh nerve involvement. None in the control group had fifth or seventh nerve deficit.
Assuntos
Nervo Facial/fisiopatologia , Hanseníase Virchowiana/fisiopatologia , Nervo Trigêmeo/fisiopatologia , Adulto , Testes Calóricos , Estudos de Casos e Controles , Feminino , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Humanos , Hanseníase Virchowiana/complicações , Masculino , Pessoa de Meia-Idade , Nervo Vestibular/fisiopatologiaRESUMO
We report on a Samoan man with dysphagia, voice hoarseness, facial erythema, and edema. Neurologic examination revealed hypesthesia at the site of the facial rash, enlarged auricular nerves, a right facial palsy, decreased gag reflexes, and voice hoarseness. Laryngoscopic examination showed paralysis of the left vocal cord, and a barium swallow revealed a possible compressive lesion. A skin biopsy specimen was diagnostic of tuberculoid leprosy. This patient has an unusual case of leprosy with multiple cranial neuropathies.
Assuntos
Doenças dos Nervos Cranianos/etiologia , Hanseníase Tuberculoide/complicações , Adulto , Nervo Facial , Nervo Glossofaríngeo , Humanos , Hanseníase Tuberculoide/patologia , Masculino , Nervo Trigêmeo , Nervo VagoRESUMO
Trigeminal trophic syndrome is an unusual condition also known as trigeminal neurotrophic ulceration or trigeminal neuropathy with nasal ulceration. The diagnosis is suggested when ulceration of the face, especially of the ala nasi, occurs in a dermatome of the trigeminal nerve that has been rendered anesthetic by a surgical or other process involving the trigeminal nerve or its central sensory connections. A history of paresthesias and self-induced trauma to the area further support the diagnosis. Neurological deficits causing trigeminal trophic syndrome may result from surgical trigeminal ablation, vascular disorders and infarction of the brainstem, acoustic neuroma, postencephalitic parkinsonism, and syringobulbia. The following etiologies of nasal ulceration should be excluded: postsurgical herpetic reactivation and ulceration, syphilis, leishmaniasis, leprous trigeminal neuritis, yaws, blastomycosis, paracoccidioidomycosis, lethal midline granuloma, pyoderma gangrenosum, Wegener's granulomatosis, and basal cell carcinoma. In the case reported here, the diagnosis of TTS was made primarily as a result of previous experience with the syndrome, underscoring the importance of physician recognition of this unusual disorder.
Assuntos
Face , Doenças Nasais/etiologia , Parestesia/complicações , Úlcera Cutânea/etiologia , Nervo Trigêmeo/fisiopatologia , Transtornos Cerebrovasculares/complicações , Humanos , Masculino , Pessoa de Meia-Idade , SíndromeRESUMO
Facial and trigeminal nerve involvement was studied in 43 leprosy patients, 5.7% of the 750 Thai national in-patients of a leprosy rehabilitation centre. Involvement of the facial nerve occurred late in the disease and had an average duration of 12.1 years. The zygomatic branches of this nerve were the most frequently affected. Hypaesthesia and anaesthesia were most often observed in the maxillary divisions. Periorbital surgical procedures to prevent severe ocular complications are evaluated and discussed.
Assuntos
Nervo Facial/patologia , Hanseníase/patologia , Nervo Trigêmeo/patologia , Adulto , Idoso , Doenças dos Nervos Cranianos/epidemiologia , Doenças dos Nervos Cranianos/patologia , Doenças dos Nervos Cranianos/cirurgia , Paralisia Facial/etiologia , Feminino , Humanos , Hanseníase/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Distribution of leprosy among slum dwellers in two areas of Bangalore City were studied. Out of a random sample of 483 it was found that 150 were suffering from leprosy while 74 tuberculoid and 25 lepromatous cases were detected, the remaining showed up as borderline and polyneuritic types. The important socio economic features and the consequences of this chronic disease have been discussed.
Assuntos
Hanseníase/epidemiologia , Áreas de Pobreza , Pobreza , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Olho/patologia , Nervo Facial/patologia , Feminino , Deformidades Adquiridas do Pé/epidemiologia , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/epidemiologia , Deformidades Adquiridas da Mão/etiologia , Humanos , Índia , Lactente , Recém-Nascido , Hanseníase/complicações , Hanseníase/terapia , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Pigmentação da Pele , Fatores Socioeconômicos , Nervo Trigêmeo/patologiaRESUMO
Modern authors estimate from 47 p. 100 to 78 p. 100 the frequency of ocular lesions in leprosy. This frequency varies according to the duration and type of the disease. These lesions may result from a paralysis of the V or VII cranial nerves, or from a bacteremia, but, more probably, from a spreading of the bacilli from the nasal cavity through the lacrymal ducts. The various lesions of each ocular structure are described with reference to the T. or L. type of leprosy.