It can be justified by the fact that motor NCS was performed in proximal segments while sensory NCS was only evaluated distally. In leprosy neuropathy,

motor nerve conduction shows higher rates of abnormality in entrapment segments such as ulnar nerve in elbow segment, peroneal nerve in peroneal head segment. So, we observed higher slowed velocity among motor than sensory nerves since only the distal segment was evaluated in the latter. In terms of NCS, and as reported by other authors, the patients worsened overall; and abnormalities Inhibitors,research,lifescience,medical persisted, particularly in the lower limbs, despite clinical improvement (Samant et al. 1999). A two- to threefold higher percentage of deterioration over improvement of sensory and motor nerve function was shown in 365 MB patients (Capadia et al. 2010). no However, the majority (64%) had already shown involvement of more than five nerves and a high prevalence of reaction (39%) upon admission

to the study. Nonetheless, some recovery could be observed when Inhibitors,research,lifescience,medical number of nerves and type of lesion were considered. Regarding nonconducting nerves, improvement was also evident in both PB and MB patients. Predominance of no conduction has been observed in sensory nerves by other authors, with rates as high as 45% in the sural nerves demonstrating improvement in 5% of these same nerves (Capadia et al. 2010) despite leprosy reaction. The differences Inhibitors,research,lifescience,medical in deterioration and recovery rates, however, may be attributed to the presence of reaction, Inhibitors,research,lifescience,medical the timely administration of steroid treatment, the longer duration of NFI, and/or type of leprosy evaluated in these studies. Again, in the present study, at leprosy diagnosis, there was a higher incidence of demyelinating lesions. However, indicative of axonal loss, low amplitudes have been found as the most important early electrodiagnostic finding in leprosy neuropathy (Singh et al. 1977; Thacker et al. Inhibitors,research,lifescience,medical 1996; Van Brakel et al. 2005). These changes have been shown to be mainly confined to compound muscle action

potential and sensory nerve action potential, particularly regarding the tender nerves. This difference may be due to the fact that Drug_discovery the patients in the present study were free of neuritis at diagnosis, as decreased velocity is produced by the inflammatory oedema of the nerves during acute neuritis (Thacker et al. 1996). The variable nerve patterns detected in the NCS lesions in conjunction with the variations in the damage found within the many nerves studied clearly highlight the above-mentioned complex nature of nerve damage in leprosy, even in such a small patient sample, suggesting that a Veliparib purchase thorough nerve evaluation is essential to be able to delineate a more realistic picture of the patient at hand. Thus, leprosy neuropathy studies should, in principle, never be limited to only one or even just a couple of particular nerves but expanded to include all the peripheral nerves. NCS allowed for the diagnosis of neuropathy better than the clinical parameters.