Association between neuropathic pain and A-Waves in Leprosy patients with type 1 and 2 reactions

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dc.contributor.authorGarbino, José A.
dc.contributor.authorNaafs, Bernard
dc.contributor.authorSalgado, Manoel Henrique [UNESP]
dc.contributor.authorUra, Somei
dc.contributor.authorVirmond, Marcos da C. L.
dc.contributor.authorSchestatsky, Pedro
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionLeiden University
dc.date.accessioned2016-03-02T12:58:31Z
dc.date.available2016-03-02T12:58:31Z
dc.date.issued2011
dc.description.abstractSummary: Neuropathic pain (NP) is a well-recognized feature of leprosy neuropathy. However, the diagnosis of NP is difficult using only clinical criteria. In the study reported here, by means of conventional nerve conduction studies, the authors sought for an association between long-latency responses and NP complaints in leprosy patients with type 1 and 2 reactions. Of the 27 ulnar nerves of leprosy patients, 18 with type 1 reaction (T1R) and 9 with type 2 reaction (T2R) were followed-up for 6 months before and after steroid treatment. Clinical characteristics of pain complaints and clinical function were assessed, as well as the presence of F- and A-waves of the ulnar nerve using nerve conduction studies. The clinical and the neurophysiologic findings were compared to note positive concordances (presence of NP and A-waves together) and negative concordances (absence of NP and A-waves together) before and after treatment. Both reactions presented a high frequency of A-waves (61.1% in T1R and 66.7% in T2R, P < 0.05) and prolonged F-waves (69.4% in T1R and 65.8% in T2R, P = 0.4). No concordances were seen between pain complaints and F-waves. However, significant concordances between NP and A-waves were observed, although restricted to the T2R group ([chi]2 = 5.65, P = 0.04). After treatment, there was a significant reduction in pain complaints, as well as the presence of F- and A-waves in both groups (P < 0.05 for all comparisons). In conclusion, the presence of A-waves correlates well with pain complaints of neuropathic characteristics in leprosy patients, especially in those with type 2 reaction. Probably, such response shares similar mechanisms with the small-fiber dysfunction seen in these patients with NP, such as demyelination, intraneural edema, and axonal sprouting. Further studies using specific tools for small-fiber assessment are warranted to confirm our findings.en
dc.description.affiliationUniversidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Engenharia de Produção, Faculdade de Engenharia de Bauru, Bauru, Av. Luiz Edmundo Coube s/n, Vargem Limpa, CEP 17033-360, SP, Brasil
dc.description.affiliationNeurophysiology Service, Instituto Lauro de Souza Lima, Bauru, São Paulo, Brazil
dc.description.affiliationEMG Unit, Serviço de Neurologia, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
dc.description.affiliationDepartment of Dermatology, Leiden University, Leyden, The Netherlands
dc.description.affiliationUnespUniversidade Estadual Paulista Júlio de Mesquita Filho, Departamento de Engenharia de Produção, Faculdade de Engenharia de Bauru, Bauru, Av. Luiz Edmundo Coube s/n, Vargem Limpa, CEP 17033-360, SP, Brasil
dc.format.extent329-332
dc.identifierhttp://dx.doi.org/10.1097/WNP.0b013e31821c3ac1
dc.identifier.citationJournal of Clinical Neurophysiology, v. 28, p. 329-332, 2011.
dc.identifier.doi10.1097/WNP.0b013e31821c3ac1
dc.identifier.issn0736-0258
dc.identifier.lattes8207092389931188
dc.identifier.urihttp://hdl.handle.net/11449/134823
dc.language.isoeng
dc.relation.ispartofJournal of Clinical Neurophysiology
dc.relation.ispartofjcr1.982
dc.relation.ispartofsjr0,629
dc.rights.accessRightsAcesso restrito
dc.sourceCurrículo Lattes
dc.titleAssociation between neuropathic pain and A-Waves in Leprosy patients with type 1 and 2 reactionsen
dc.typeArtigo
unesp.author.lattes8207092389931188
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Engenharia, Baurupt
unesp.departmentEngenharia de Produçãopt

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