Effect of steroid therapy on parameters of peripheral autonomic dysfunction in leprosy patients with acute neuritis

Recent electrophysiological studies on peripheral autonomic dysfunction in leprosy patients show a high prevalence of autonomic dysfunction as measured by abnormal vasomotor reflexes (VMR) and absent sympathetic skin response (SSR). Nothing is known about the reversibility of these autonomic parameters with treatment. Since there is evidence that small fiber function may be the most reversible component in neuropathies, we measured the effect of steroid treatment on autonomic parameters together with motor and sensory functions in leprosy patients with acute neuritis. Control subjects were investigated for repeatability testing of autonomic function. Due to a relatively high variability on repeat VMR testing in the controls, we defined a change in VMR testing as a change of > 30%. With this definition, the VMR of 14.8% of the patients improved, 75% remained unchanged, and 10.2% worsened. Absent SSR became positive in 16.6% and remained unchanged in 83.4%. Improvement in sensory motor functions was seen in 21.2% and 1.3% of the patients, respectively.

Neuritis and rifampicin

The authors present their observation of neuritis precipited or by RFM in 20 patients all hospitalized except three. The authors belive that, as per literature, none of the drugs used in the MDT programs reach the nerves, however once a nerve is damaged by ischemia, drug to penetrate and can cause further damage; this explains why many patients asymptomatic before therapy, complain of neural pain after starting the therapy.

The treatment of lepra reaction in lepromatous leprosy. Fifteen years experience with thalidomide

The history of the treatment of lepra reaction has involved the trial of many different drugs; some have proven effective and some have not. The problem has been to find a treatment with minimal side effects. This paper deals with the treatments which have been tried and the success that has been achieved with talidomide.

A talidomida no contrôle da dor nas neurites lepróticas / Thalidomide in the control of pain in leprotic neuritis

The authors report the effect of thalidomide in controlling neuralgic manifestations of leprosy in 27 patients. The drug was given orally at the dosage of 100mg twice a day for 5 days, 100mg daily for a weeek and 100 mg each 48 hours in the subsequent days . Only in 3 cases there were mild side effects. Pain was reduced and the authors relate that 16 cases were considered excellent, 9 cases good and 2 cases fair. They conclude that the drug is efficient in the control of pain in leprotic neuritis.