Surgical treatment of type I neuritis in a teenage boy with borderline tuberculoid leprosy

Abstract

Exacerbation of the immune response against Mycobacterium leprae can lead to neuritis, which is commonly treated via immunosuppression with corticosteroids. Early neurolysis may be performed concurrently, especially in young patients with a risk of functional sequelae. We report the case of a young patient experienced intense pain in the left elbow one year after the treatment of tuberculoid-tuberculoid leprosy. The pain was associated with paresthesias in the ulnar edge and left ulnar claw. After evaluation, the diagnosis was changed to borderline tuberculoid leprosy accompanied with neuritis of the left ulnar nerve. Early neurolysis resulted in rapid reduction of the pain and recovery of motor function.

Progression of peripheral nerve injury in leprosy: Evaluation of the effect of nerve decompression surgery in an endemic region of Brazil

“…11 According to Sette et al, the early neurolysis is an alternative therapy that should not be neglected and can be concurrently performed with the administration of corticosteroids, particularly in young patients at risk for functional sequelae or significant nerve involvement. 12 According to Malaviya, the time between the diagnosis of neuropathy and the surgery is essential for the good result of the procedure. 11 In our study, as most of our sample comes from other municipalities or states (68.1%), we do not know the date of the onset of neuropathy; however, we can say that the time between the start of treatment with MDT and the performing of the surgeries had no significant impact on the results of the procedure.…”