01941nas a2200373   4500000000100000008004100001260001300042653001500055653001000070653003800080653001000118653002100128653001100149653000900160653001100169653002800180653001200208653000900220653001600229653002100245653002900266653001100295653002400306653000900330653002000339100002100359700002100380700001500401245008600416300001200502490000700514520103200521022001401553       2000                            d  c2000 Jul10aAdolescent10aAdult10aAutonomic Nervous System Diseases10aChild10aCold Temperature10aFemale10aHand10aHumans10aLaser-Doppler Flowmetry10aleprosy10aMale10aMiddle Aged10aMuscle, Skeletal10aMuscle, Smooth, Vascular10aReflex10aRegional Blood Flow10aSkin10aUltrasonography1 aWilder-Smith E P1 aWilder-Smith A J1 aNirkko A C00aSkin and muscle vasomotor reflexes in detecting autonomic dysfunction in leprosy.  a1105-120 v233 a<p>There are few tests to assess the function of small unmyelinated nerve fibers. One established test is the skin vasomotor reflex (SVMR), which uses laser doppler flow velocimetry. The SVMR has the disadvantages of being susceptible to interference (from change of temperature and alerting stimuli) and of requiring expensive equipment. An ultrasound doppler method, which is less expensive, can be used to detect muscle vasomotor reflex (MVMR) activity. We sought to compare the efficacy of these two methods in detecting dysfunction of small unmyelinated nerve fibers in patients with leprosy. SVMR was shown to be less sensitive (P < 0.01) and specific (P < 0.001) than MVMR. The favorable results of MVMR may be attributed to its lesser susceptibility to interfering sympathetic vasoconstriction from alerting stimuli. MVMR also reflects larger areas of blood vessel innervation than the laser doppler method. In leprosy, nerve damage is typically patchy and may be missed by the smaller sampling of the laser method.</p>  a0148-639X