Recording cutaneous silent period parameters in hereditary and acquired neuropathies.

BACKGROUND: Cutaneous silent period (CSP) is the interruption in muscle activity after painful stimulation of a sensory nerve. OBJECTIVE: The aim of the present study is to assess CSP changes in patients with polyneuropathy (PNP). METHODS: The present study was carried out to assess CSP in individuals with diabetes (DM) and Charcot-Marie-Tooth (CMT) disease. The sample comprised 24 individuals with DM, 10 individuals with CMT1 disease, and 10 individuals with CMT2 disease. The control group (CG) consisted of 59 individuals. RESULTS: The mean latencies recorded for the upper limbs in the CG were 79.2 milliseconds (onset latency), 69.3 milliseconds (50% reduction latency), 112.2 milliseconds (end latency), and 33.1 milliseconds (CSP duration). On the other hand, the mean latencies recorded for the lower limbs were 99.0 milliseconds (onset latency), 85.0 milliseconds (50% reduction latency), 136.9 milliseconds (end latency), and 38.2 milliseconds (CSP duration). The mean latencies recorded for the CG were significantly lower than the ones recorded for other groups, both in the upper and lower limbs. CONCLUSIONS: Cutaneous silent period values recorded for the CG in the present study were close to the ones reported in studies available in the literature. Abnormal CSP parameters were observed in the group of individuals with PNP. The end latency in the lower limbs helped differentiating the demyelinating subgroup from the axonal one.

ANTECEDENTES: Período de silêncio cutâneo (PSC) é uma interrupção da atividade muscular após a estimulação dolorosa de um nervo sensitivo. OBJETIVO: O presente estudo tem como objetivo avaliar alterações do PSC em indivíduos com polineuropatia. MéTODOS: O presente estudo avaliou PSC em indivíduos com diabetes mellitus (DM) e com doença de Charcot-Marie-Tooth (CMT). A amostra compreendia 24 indivíduos com DM, 10 indivíduos com CMT tipo 1 e 10 indivíduos com CMT tipo 2. Um grupo controle continha 59 indivíduos. RESULTADOS: A média das latências do PSC registradas nos membros superiores no grupo controle foi 79,2 milissegundos (latência de início), 69,3 milissegundos (latência com redução de 50%), 112,2 milissegundos (latência final) e 33,1 milissegundos (duração do PSC). Por outro lado, a média das latências do PSC registradas nos membros inferiores foi 99,0 milissegundos (latência de início), 85,0 milissegundos (latência com redução de 50%), 136,9 milissegundos (latência final) e 38,2 milissegundos (duração do PSC). A média das latências registradas no grupo controle foi significativamente menor do que as registradas nos outros grupos (DM e CMT), tanto nos membros inferiores quanto nos superiores. CONCLUSõES: Os valores do PSC registrados no grupo controle no presente estudo estiveram próximos aos reportados na literatura. Parâmetros anormais foram observados no grupo de indivíduos com polineuropatia. A latência final do PSC obtida nos membros inferiores ajudou a diferenciar os subgrupos desmielinizantes e axonais.

Recording cutaneous silent period parameters in hereditary and acquired neuropathies / Registro do período de silêncio cutâneo em neuropatias adquiridas e hereditárias

Abstract Background Cutaneous silent period (CSP) is the interruption in muscle activity after painful stimulation of a sensory nerve. Objective The aim of the present study is to assess CSP changes in patients with polyneuropathy (PNP). Methods The present study was carried out to assess CSP in individuals with diabetes (DM) and Charcot-Marie-Tooth (CMT) disease. The sample comprised 24 individuals with DM, 10 individuals with CMT1 disease, and 10 individuals with CMT2 disease. The control group (CG) consisted of 59 individuals. Results The mean latencies recorded for the upper limbs in the CG were 79.2 milliseconds (onset latency), 69.3 milliseconds (50% reduction latency), 112.2 milliseconds (end latency), and 33.1 milliseconds (CSP duration). On the other hand, the mean latencies recorded for the lower limbs were 99.0 milliseconds (onset latency), 85.0 milliseconds (50% reduction latency), 136.9 milliseconds (end latency), and 38.2 milliseconds (CSP duration). The mean latencies recorded for the CG were significantly lower than the ones recorded for other groups, both in the upper and lower limbs. Conclusions Cutaneous silent period values recorded for the CG in the present study were close to the ones reported in studies available in the literature. Abnormal CSP parameters were observed in the group of individuals with PNP. The end latency in the lower limbs helped differentiating the demyelinating subgroup from the axonal one.

Resumo Antecedentes Período de silêncio cutâneo (PSC) é uma interrupção da atividade muscular após a estimulação dolorosa de um nervo sensitivo. Objetivo O presente estudo tem como objetivo avaliar alterações do PSC em indivíduos com polineuropatia. Métodos O presente estudo avaliou PSC em indivíduos com diabetes mellitus (DM) e com doença de Charcot-Marie-Tooth (CMT). A amostra compreendia 24 indivíduos com DM, 10 indivíduos com CMT tipo 1 e 10 indivíduos com CMT tipo 2. Um grupo controle continha 59 indivíduos. Resultados A média das latências do PSC registradas nos membros superiores no grupo controle foi 79,2 milissegundos (latência de início), 69,3 milissegundos (latência com redução de 50%), 112,2 milissegundos (latência final) e 33,1 milissegundos (duração do PSC). Por outro lado, a média das latências do PSC registradas nos membros inferiores foi 99,0 milissegundos (latência de início), 85,0 milissegundos (latência com redução de 50%), 136,9 milissegundos (latência final) e 38,2 milissegundos (duração do PSC). A média das latências registradas no grupo controle foi significativamente menor do que as registradas nos outros grupos (DM e CMT), tanto nos membros inferiores quanto nos superiores. Conclusões Os valores do PSC registrados no grupo controle no presente estudo estiveram próximos aos reportados na literatura. Parâmetros anormais foram observados no grupo de indivíduos com polineuropatia. A latência final do PSC obtida nos membros inferiores ajudou a diferenciar os subgrupos desmielinizantes e axonais.

Clinical and epidemiological indicators and spatial analysis of leprosy cases in patients under 15 years old in an endemic area of Northeast Brazil: an ecological and time series study.

OBJECTIVE: This study aimed to analyse the clinical and epidemiological indicators, temporal trends and the spatial distribution of leprosy in patients under 15 years old in an endemic area of Northeast Brazil. DESIGN: Regional surveillance study of all reported cases. SETTING: State of Sergipe, endemic area of Northeast Brazil. METHODS: An ecological and time series study was conducted, based on secondary data reported by the Brazilian Information System on Notifiable Diseases for leprosy cases diagnosed in Sergipe state (2002-2015). The analysis of temporal trends was performed using the Joinpoint Regression Programme through Poisson regression. We performed spatial analysis by Kernel estimator and Moran index. RESULTS: The incidence rate was reduced from 6.29 to 3.78 cases per 100 000 inhabitants in 2002 and 2015, respectively. However, Sergipe was still classified as highly endemicity in 2015. The mean number of household contacts (HHC) examined was significantly lower than those registered. Clinical data indicated that 21.4% of the patients developed leprosy reactions, and 31.3% presented with some physical disability in the multibacillary groups. Patients diagnosed by examination within the HHC presented better indicators, such as lower percentage of leprosy reaction and physical disability. Spatial analysis showed the most risk areas distributed on the northeast and cities around the capital, Aracaju. CONCLUSION: The data indicate that there is a persistence of active Myobacterium leprae transmission and a delay in disease detection, following a pattern of high endemicity in many municipalities. The early detection by HHC examination is important to stop transmission and also to detect the cases in a less severe state.