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Report of the sub-group on rehabilitation

Abstract
As a matter of policy, all persons suffering from leprosy should have the benefit of a full physical examination, with special attention being paid to the skin, the peripheral nerves and the eyes. We particularly emphasize that all physicians responsible for the management of leprosy patients should familiarize themselves with the techniques for monitoring sensory and motor nerve function deficit, if necessary calling upon the Department of Neurology of the local hospital for appropriate investigations. They will then be able to assess the indications for any surgical intervention which may be necessary. All cases of acute neuritis, especially those developing in the course of 'reversal' reaction, nerve function be systematically monitored daily and anti-inflammatory drugs, notably steroids, given in adequate dosage. The affected limb should be splinted in the position of physiological rest. There is growing evidence that surgical decompression of nerves has a place in these cases, especially if carried out early and that it may also be beneficial in nonreacting cases, in particular surgical decompression of the posterior tibial nerve in the neighbourhood of the medial malleolus has been reported as giving good results in cases of neuropathic ulceration of the foot. Hospitalization should be as short as possible to ensure the minimum dislocation of the patient from his home and his employment. With due regard to the preservation of confidentiality, arrangements must be made for the proper dermatological examination of family contacts and BCG vaccination of the children considered. As a general rule, we do not recommend chemoprophylaxis. Leprosy patients should not be subjected to restrictive regulations regarding their employment whether public or private. Arrangements should be made for patients to change their job if necessary on account of disability

More information

Type
Journal Article
Author
Browne S G
Wheate H W
Bourrel P

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