02812nas a2200481   4500000000100000008004100001260001300042653001500055653001000070653000900080653001000089653001900099653002600118653001100144653001100155653001200166653002000178653000900198653001600207653002700223653001500250653003900265653002400304653003200328653002300360653003000383653002800413653001000441100001800451700001200469700001800481700001800499700001700517700001300534700001900547245007900566856005100645300001000696490000700706050003200713520157100745022001402316       2003                            d  c2003 Mar10aAdolescent10aAdult10aAged10aChild10aCohort Studies10aDisability Evaluation10aFemale10aHumans10aleprosy10aLogistic Models10aMale10aMiddle Aged10aNeurologic Examination10aOdds Ratio10aPeripheral Nervous System Diseases10aProspective Studies10aSensitivity and Specificity10aSensory Thresholds10aSeverity of Illness Index10aSomatosensory Disorders10aTouch1 aKoelewijn L F1 aMeima A1 aBroekhuis S M1 aRichardus J H1 aMitchell P D1 aBenbow C1 aSaunderson P R00aSensory testing in leprosy: comparison of ballpoint pen and monofilaments.  uhttps://leprosyreview.org/article/74/2/19-2192  a42-520 v74  aInfolep Library - available3 a<p>The 10 g monofilament has been replaced by the ballpoint pen in routine sensory testing of nerves in leprosy control in Ethiopia. Results of sensory testing between the ballpoint pen and different monofilaments on hands and feet were compared. Ballpoint pen underdiagnosis of loss of sensation was defined to occur when the pen was felt and the monofilament was not. Differences were evaluated both for individual test points (test point level) and for the test points of extremities collectively (extremity level). An extremity (either a hand or a foot) was defined as having sensory nerve function impairment (SNFI) if a supplying nerve had SNFI, which was the case when sensation was absent in two or more test points in the area supplied by that nerve. At test point level, the percentages with ballpoint pen underdiagnosis relative to the 2, 10, 20 and 50 g monofilaments were 40, 21, 9 and 7%, respectively, in the hands, and 47, 30, 15 and 7% in the feet. Ballpoint pen underdiagnosis percentages of SNFI at extremity level were 32, 18, 8 and 9% in the hands, and 37, 26, 14 and 6% in the feet. The risk of ballpoint pen underdiagnosis appears to be higher in extremities without visible damage. In conclusion, substantial levels of underdiagnosis of sensory loss with the ballpoint pen were observed. However, the consequences for the prognosis of treatment with corticosteroids in patients with the more subtle sensation loss noted here need to be established. Development and testing of guidelines is a prerequisite for the use of the ballpoint pen.</p>  a0305-7518