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Effect of corticosteroid usage combined with multidrug therapy on nerve damage assessed using nerve conduction studies: a prospective cohort study of 365 untreated multibacillary leprosy patients.
J Clin Neurophysiol. 2010 Feb; 27(1):38-47.JC

Abstract

The purpose of this study is to determine the extent of nerve involvement and to study the effect of corticosteroids combined with multidrug therapy on nerve damage in leprosy patients using sensory and motor nerve conduction studies. A cohort of 365 untreated multibacillary leprosy patients were prospectively studied using sensory and motor nerve conduction studies on upper and lower limb nerves. They were subgrouped as those to be treated with 12-week regimen of corticosteroids for reaction and/or neuritis or silent neuropathy of <6 months duration along with 12-month multidrug therapy (group A), and those with no reaction were treated with multidrug therapy only (group B). Analysis was performed using SPSS version 10.0. Significance of association was tested using chi(2) test. At registration, abnormality by nerve conduction studies was seen in 92% of patients and majority (65%) showing involvement of more than five sensory and motor nerves. Sensory nerve abnormalities were higher (52%) than motor (37%) (P < 0.001). Affection of sensory and motor nerves was higher in group A (P < 0.001). Notably, 40% nerves in group B also showed impairment at 0 month. This implies that almost all patients showed abnormal nerve conduction studies at onset regardless of reaction, proving nerve damage is more widespread than envisaged. At 18 months, overall percentile deterioration (23%) of nerves was higher than improvement (9%) (P < 0.001) indicating that corticosteroids combined with multidrug therapy failed to significantly improve the nerve status. Sensory nerve (57%) affection was significantly higher than motor (46%) (P < 0.001). Moreover, percentile deterioration of sensory nerves was higher in group A (P < 0.001) implying corticosteroids is not very efficacious in the prevention or reversal of nerve damage. Electrophysiological tests provide valuable information for detecting nerve function impairment and evaluating appropriate therapeutic regimens.

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Authors+Show Affiliations

Capadia GD
Foundation for Medical Research, Maharashtra, India.
Shetty VP
No affiliation info available
Khambati FA
No affiliation info available
Ghate SD
No affiliation info available

MeSH

AdolescentAdrenal Cortex HormonesAdultChildFemaleFollow-Up StudiesHumansLeprostatic AgentsLeprosy, MultibacillaryMaleMiddle AgedMotor NeuronsNeural ConductionNeuritisPeripheral NervesPeripheral Nervous System DiseasesProspective StudiesSensory Receptor CellsTreatment OutcomeYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20087206

Citation

Capadia, Gospi Dolly, et al. "Effect of Corticosteroid Usage Combined With Multidrug Therapy On Nerve Damage Assessed Using Nerve Conduction Studies: a Prospective Cohort Study of 365 Untreated Multibacillary Leprosy Patients." Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society, vol. 27, no. 1, 2010, pp. 38-47.
Capadia GD, Shetty VP, Khambati FA, et al. Effect of corticosteroid usage combined with multidrug therapy on nerve damage assessed using nerve conduction studies: a prospective cohort study of 365 untreated multibacillary leprosy patients. J Clin Neurophysiol. 2010;27(1):38-47.
Capadia, G. D., Shetty, V. P., Khambati, F. A., & Ghate, S. D. (2010). Effect of corticosteroid usage combined with multidrug therapy on nerve damage assessed using nerve conduction studies: a prospective cohort study of 365 untreated multibacillary leprosy patients. Journal of Clinical Neurophysiology : Official Publication of the American Electroencephalographic Society, 27(1), 38-47. https://doi.org/10.1097/WNP.0b013e3181cb426d
Capadia GD, et al. Effect of Corticosteroid Usage Combined With Multidrug Therapy On Nerve Damage Assessed Using Nerve Conduction Studies: a Prospective Cohort Study of 365 Untreated Multibacillary Leprosy Patients. J Clin Neurophysiol. 2010;27(1):38-47. PubMed PMID: 20087206.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of corticosteroid usage combined with multidrug therapy on nerve damage assessed using nerve conduction studies: a prospective cohort study of 365 untreated multibacillary leprosy patients. AU - Capadia,Gospi Dolly, AU - Shetty,Vanaja Prabhakar, AU - Khambati,Fatema Abbas, AU - Ghate,Sunil Dattatraya, PY - 2010/1/21/entrez PY - 2010/1/21/pubmed PY - 2010/4/16/medline SP - 38 EP - 47 JF - Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society JO - J Clin Neurophysiol VL - 27 IS - 1 N2 - The purpose of this study is to determine the extent of nerve involvement and to study the effect of corticosteroids combined with multidrug therapy on nerve damage in leprosy patients using sensory and motor nerve conduction studies. A cohort of 365 untreated multibacillary leprosy patients were prospectively studied using sensory and motor nerve conduction studies on upper and lower limb nerves. They were subgrouped as those to be treated with 12-week regimen of corticosteroids for reaction and/or neuritis or silent neuropathy of <6 months duration along with 12-month multidrug therapy (group A), and those with no reaction were treated with multidrug therapy only (group B). Analysis was performed using SPSS version 10.0. Significance of association was tested using chi(2) test. At registration, abnormality by nerve conduction studies was seen in 92% of patients and majority (65%) showing involvement of more than five sensory and motor nerves. Sensory nerve abnormalities were higher (52%) than motor (37%) (P < 0.001). Affection of sensory and motor nerves was higher in group A (P < 0.001). Notably, 40% nerves in group B also showed impairment at 0 month. This implies that almost all patients showed abnormal nerve conduction studies at onset regardless of reaction, proving nerve damage is more widespread than envisaged. At 18 months, overall percentile deterioration (23%) of nerves was higher than improvement (9%) (P < 0.001) indicating that corticosteroids combined with multidrug therapy failed to significantly improve the nerve status. Sensory nerve (57%) affection was significantly higher than motor (46%) (P < 0.001). Moreover, percentile deterioration of sensory nerves was higher in group A (P < 0.001) implying corticosteroids is not very efficacious in the prevention or reversal of nerve damage. Electrophysiological tests provide valuable information for detecting nerve function impairment and evaluating appropriate therapeutic regimens. SN - 1537-1603 UR - https://www.unboundmedicine.com/medline/citation/20087206/Effect_of_corticosteroid_usage_combined_with_multidrug_therapy_on_nerve_damage_assessed_using_nerve_conduction_studies:_a_prospective_cohort_study_of_365_untreated_multibacillary_leprosy_patients_ L2 - https://doi.org/10.1097/WNP.0b013e3181cb426d DB - PRIME DP - Unbound Medicine ER -
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