02443nas a2200193   4500000000100000008004100001260001000042653002100052100001200073700001200085700001300097700001400110245014400124856009800268300001200366490000700378520185000385022001402235       2021                            d  bLepra10aGeneral Medicine1 aSajid I1 aArora M1 aNawani E1 aMishra KN00aThe carpal tunnel syndrome in leprosy: a long term follow up of steroids versus surgical decompression for median nerve neuritis in leprosy  uhttps://leprosyreview.org/admin/public/api/lepra/website/getDownload/6141772eafaac11e8f7c1e1e  a218-2240 v923 aLeprosy is a stigmatizing and neglected tropical disease still prevalent in various countries of the world. According to WHO reports from 159 countries, 208,619 new leprosy cases were reported globally in 2018, of which Brazil, India, and Indonesia accounted for 79.6%. With the preference of M. leprae for cooler areas, peripheral nephropathy of the hand and feet are commonly seen in leprosy patients. Peripheral nerve involvement may result in the development of deformities. The ulnar nerve is commonly involved followed by median nerve, common peroneal nerve, facial nerve and the radial nerve in descending order. High doses of steroids are commonly given in peripheral neuropathies, but 70–75% cases still develop deformity with this treatment. Surgical decompression of involved nerves, though not so common, is another modality attempted for nerve damage prevention. In the present study, we compared steroid therapy alone with steroids plus surgical decompression, for carpal tunnel syndrome in leprosy cases.
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Methods<br>
52 patients with involvement of 70 median nerves (18 bilateral) were enrolled. They had palpable median nerves, along with sensory and motor loss. 16 patients were lost to follow up by 2 years, so that 36 patients with 50 median nerves (14 bilateral) remained for review. These cases were randomly divided into two groups: one group was given steroids while the second group was given steroids along with surgical nerve decompression. The results were evaluated for improvement or deterioration of the sensory and motor symptoms, along with pain.
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Conclusion<br>
The results support the proposition that surgical decompression of the nerve together with steroid treatment, is a better option to prevent the progression of deformities due to median nerve involvement, than steroids alone.   a2162-8807