Ulnar Nerve Decompression in Neural Form of Leprosy in Childhood

Abstract

A B S T R A C TLeprosy is a disease that potentially affects adults with a long latency period of 3 to 5 years. However, children are prone to acquire the disease especially in places of high prevalence and poor epidemiologic control. The surgical decompression is an ancillary method of treatment, although recent investigations call attention for the similarity of results of conservative management. The objective of this study, then, was to call attention for surgical indication in leprosy patients with ulnar impairment soon after failure of conservative management. The authors describe and analyze a case of an outpatient operated child with ulnar nerve involvement by leprosy after 1 year of clinical treatment and failure. The predominant symptoms were pain and physical deformity. There was a great improvement following the surgery even after delayed operation. The surgical intervention is sometimes necessary to avoid deformities although more randomized series must confi rm the superiority of surgery in relation to clinical management in some cases.

Surgery for ulnar nerve decompression and drainage of a caseous granuloma in a neural form of leprosy in children

“…In the case of neuropathy in children, conservative drug treatment can be tried for Stage I neuritis, but these children must be closely monitored. 5,6,10 In this paper we present a rare case of Stage III right ulnar neuropathy in a 13-year-old child who underwent surgical decompression. Surgical approach of the caseous granuloma is the most appropriate treatment option for these patients, because of the advanced stage of the lesion.…”

“…Surgical decompression is an auxiliary method of treatment and prevention of irreversible neurological deformities and sequelae, and should be correctly and promptly indicated. In the case of neuropathy in children, conservative drug treatment can be tried for Stage I neuritis, but these children must be closely monitored 5,6,10 …”

“…In the case of neuropathy in children, conservative drug treatment can be tried for Stage I neuritis, but these children must be closely monitored. 5 , 6 , 10…”

“…Motor deficit causes claw hand and foot drop. Loss of sensation leads to ulcers and trophic lesions 6 …”

“…Loss of sensation leads to ulcers and trophic lesions. 6 The involvement of neurological disease with indication for surgery in children under 15 years of age is quite rare and there are few reports in the literature.…”