Pedro Henrique Sirotheau Corrêa Alves, Fernanda de Oliveira Cirino, Leonardo Peixoto Garcia, João Paulo Moreira Fernandes, Andrea De Martino Luppi, Douglas Eulálio Antunes, Raquel Campos Pereira, Wilson Marques Junior, Isabela Maria Bernardes Goulart, Diogo Fernandes Dos Santos
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引用次数: 0
Abstract
Background: Carpal tunnel syndrome (CTS) has already been described as a possible form of neural leprosy presentation. However, the median nerve can be involved in this neuropathy in proximal segments and, sometimes, with an asymmetric impairment of the digital branches.
Objective: To detail the pattern of median nerve impairment through nerve conduction study (NCS) and ultrasound evaluation.
Methods: This cross-sectional study comprises 15 primary neural leprosy (PNL) patients and 14 patients with CTS who underwent peripheral nerve ultrasonography and NCS evaluation.
Results: From the total, 92.8% of patients with CTS and 80% with PNL had bilateral impairment of the median nerve, with 27 nerves in each group. Considering the cross-sectional area (CSA) of the tunnel (Mt) segment, 63% of the nerves in the CTS and 74.1% in the PNL groups were found to be thickened, with an average CSA of 13.4 ± 4.4 and 12.4 ± 4.6, respectively (p = 0.18). The CSA of the proximal tunnel (Mpt) segment showed thickening in only 3.7% in the CTS group and 96.3% in the PNL (p < 0.0001), with an average of 6.6 ± 1.3 and 17.0 ± 6.7, respectively (p < 0.001). Finally, 88.9% of the nerves in the PNL group and only 7.4% in the CSA (p < 0.0001) showed a reduction in conduction velocity in the distal forearm, with an average of 41.0 ± 6.3 and 53.2 ± 5.2, respectively (p < 0.0001).
Conclusion: The presence of neural thickening and demyelinating impairment in the segments proximal to the carpal tunnel favors the diagnosis of leprosy.
背景：腕管综合征（CTS）已被描述为神经性麻风病的一种可能表现形式。然而，正中神经可累及近端神经节段，有时指支不对称损伤。目的：通过神经传导研究（NCS）和超声检查，探讨正中神经损伤的表现。方法：对15例原发性神经性麻风（PNL）患者和14例CTS患者进行周围神经超声检查和NCS评价。结果：92.8%的CTS患者双侧正中神经受损，80%的PNL患者双侧正中神经受损，每组27条神经受损。从隧道（Mt）段的横断面积（CSA）来看，CTS组63%的神经增厚，PNL组74.1%的神经增厚，平均CSA分别为13.4±4.4和12.4±4.6 （p = 0.18）。CTS组Mpt节段CSA增厚率仅为3.7%，PNL组为96.3% （p p p p）结论：腕管近段神经增厚及脱髓鞘损伤有利于麻风的诊断。
期刊介绍：
Arquivos de Neuro-Psiquiatria is the official journal of the Brazilian Academy of Neurology. The mission of the journal is to provide neurologists, specialists and researchers in Neurology and related fields with open access to original articles (clinical and translational research), editorials, reviews, historical papers, neuroimages and letters about published manuscripts. It also publishes the consensus and guidelines on Neurology, as well as educational and scientific material from the different scientific departments of the Brazilian Academy of Neurology.
The ultimate goals of the journal are to contribute to advance knowledge in the areas of Neurology and Neuroscience, and to provide valuable material for training and continuing education for neurologists and other health professionals working in the area. These goals might contribute to improving care for patients with neurological diseases. We aim to be the best Neuroscience journal in Latin America within the peer review system.
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