Leprosy Mailing List – May 4, 2018
Ref.: (LML) To differentiate between diabetic neuropathy and pure neuritic leprosy neuropathy
From: James Wilson, New Hampshire, USA
Dear Pieter,
Interesting ongoing conversation. I have been decompressing nerves as a student of doctor Dellon for the past 16 years in Ecuador and in the USA. I run a surgical team that performs peripheral nerve surgery on upper and lower extremity nerves in Hansen's patients in South America. Our results have been excellent in long-term follow-up for return of motor function, decreased limb pain and increased sensation.
The Hansen nerves do not have amyloid deposition such as what we see in the diabetic patient however they are quite swollen and show obvious signs of impingement at the fibro-osseous tunnels at the joint levels where these nerves are decompressed in both upper and lower extremities.
Interestingly we have had some patients with diabetes and Hansen's Disease which creates a real double crush type syndrome on the nerve.
Sincerely,
Dr. James Wilton
Valley Regional Hospital Claremont, New Hampshire, USA
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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