British Leprosy Relief Association
Correlation between clinical tests and electroneuromyography for the diagnosis of leprosy neuropathy
LimaPedro Olavo De Paulaa
CunhaFrancisco Marcos Bezerrab
GonçalvesHeitor De Sáb
AiresMaria Araci Pontesb
De AlmeidaRosa lívia Freitasc
KerrLigia Regina Franco Sansigoloc
aDepartment of Physical Therapy, Federal University of Ceara, Brazil
bDona Libania Dermatology Center, Brazil
cDepartment of Community Health, Federal University of Ceara, Brazil
Correspondence to: Pedro Olavo de Paula Lima, Department of Physical Therapy. Permanent address: Rua Alexandre Baraúna, 949, Fortaleza, CE, 60430-110, Brazil (Tel: +55 85 33668632; Fax: +55 85 33668002; e-mail: firstname.lastname@example.org)
In leprosy, sensory function of nerves is evaluated with monofilaments test and the motor function with voluntary muscle test, however electroneuromyography is considered as the gold-standard tool.
This study aimed: i) to evaluate the correlation between clinical tests and electroneuromyography for the diagnosis of leprosy neuropathy; and ii) to identify the prevalence of leprosy neuropathy and the most compromised peripheral nerves in leprosy.
We analysed the data from a nested case-control study that identified 166 patients diagnosed with leprosy neuropathy confirmed by electromyography. This study was designed for an analysis of correlation between the diagnostic tests.
The most prevalent type of the neural damage was the sensory and motor multiple mononeuropathy, observed in 62 (37.3%) cases. The highest prevalence was the ulnar nerve in 67 (40.3%) cases. Agreement specified by nerves was moderate, ranging from k = 0.58 in the deep peroneal nerve to k = 0.41 in the posterior tibial nerve). Overall agreement between the clinical tests and electroneuromyography was very poor. Monofilaments test with k = 0.02 (95% CI 0.00 - 0.12) and voluntary muscle test with 016 (95% CI 0.04 to 0.28, P = 0.01).
There is a low to moderate correlation between clinical tests (monofilaments and voluntary muscle tests) and the electroneuromyography examination. The most prevalent type of neural impairment was the sensory and motor multiple mononeuropathy, and the most affected nerve was the ulnar.