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Clinical and Neurophysiological Features of Leprosy Patients with Neuropathic Pain

2018; American Society of Tropical Medicine and Hygiene; Volume: 98; Issue: 6 Linguagem: Inglês

10.4269/ajtmh.17-0817

1476-1645

Louise Giesel, Izabela Jardim Rodrigues Pitta, Raquel Silveira, Lígia Rocha Andrade, Robson Teixeira Vital, José Augusto da Costa Nery, Mariana de Andréa Vilas Boas Hacker, Euzenir Nunes Sarno, Márcia Rodrigues Jardim,

Pain Mechanisms and Treatments

Neural pain is a frequent symptom in leprosy disease. There is a paucity of data regarding neural pain diagnostics resulting in common prescriptive errors when neuritis is confused with neuropathic or mixed nociceptive-neuropathic pain. The present study identified important demographic, clinical, and neurophysiological features of 42 leprosy neuropathy patients presenting neuropathic pain (NP). During routine evaluations, patients were selected asking if they had ever experienced neural pain. Data analyses of their pain characteristics, clinical examination results, and both the Douleur Neuropathique 4 Questionnaire and Hamilton Depression Scale scores were used to classify these patients. The most common word they used to describe the sensation of pain for 25 (60%) of these patients was "burning." In the early stages of the disease and before leprosy diagnosis, 19 (45%) had already complained about NP and leprosy treatment was unable to prevent its occurrence in 15 (36%). Leprosy reactions, considered NP risk factors, occurred in 32 (76%) cases. Knowledge of typical NP characteristics could be used to develop more effective therapeutic approaches for a notoriously difficult-to-treat pain condition.