02242nas a2200397 4500000000100000008004100001260001600042653001500058653001000073653000900083653002200092653001100114653001100125653002800136653001200164653000900176653002100185653001600206653002900222653001700251653002200268653001100290653002400301653000900325653003100334100001400365700001300379700001400392700001200406245014300418300001000561490000800571050001600579520123500595022001401830 1996 d c1996 Mar 0810aAdolescent10aAdult10aAged10aElectrophysiology10aFemale10aHumans10aLaser-Doppler Flowmetry10aleprosy10aMale10aMicrocirculation10aMiddle Aged10aMuscle, Smooth, Vascular10aNerve Fibers10aNeural Conduction10aReflex10aSensation Disorders10aSkin10aSympathetic Nervous System1 aAbbot N C1 aBeck J S1 aMostofi S1 aWeiss F00aSympathetic vasomotor dysfunction in leprosy patients: comparison with electrophysiological measurement and qualitative sensation testing. a57-600 v206 aABBOTT 19963 a

Testing of skin vasomotor reflexes (VRs) by laser Doppler flowmetry (LDF) is now a recognised method of measuring peripheral dysautonomia. To assess its specificity as an indicator of impairment to unmyelinated autonomic fibres, VR testing at the fingerpulp was compared with standard qualitative sensation (QST) and with sensory electrophysiological (SNVC) measurements in 39 Iranian leprosy patients. There was a significant relationship between VR and SNCV values (but not QST): these were jointly measurable in 38.5% of fingers, and jointly absent in 35.3% of fingers which also showed significantly reduced LDF perfusion and skin temperatures. However, in 10.3% of fingers, predominantly index and otherwise apparently healthy, VRs were absent but SNCV present, suggesting early sub-clinical autonomic impairment. In a further 16% of fingers, predominantly ulnar and with poor microcirculation, intact (though impaired) VRs could be recorded despite the absence of SNCV responses, suggesting sparing or regeneration of these fibres. This evidence suggests that where there is heterogeneity of nerve damage a combination of VR and electrophysiological testing can indicate the functional status of distinct fibre types.

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