01839nas a2200241   4500000000100000008004100001653004700042653001200089653002100101100001400122700001600136700001700152700001500169700001000184700001400194700001600208700002400224245003300248300001000281490000700291520128500298022001401583       2016                            d10aDouleur Neuropathique en 4 questions (DN4)10aleprosy10aneuropathic pain1 aRaicher I1 aStump PRNAG1 aBaccarelli R1 aMarciano L1 aUra S1 aVirmond M1 aTeixeira MJ1 aCiampi de Andrade D00aNeuropathic pain in leprosy.  a59-650 v343 a<p>Nerve impairment is a key clinical aspect of leprosy and may present the distribution of mononeuropathy or multiple nerve trunks, small cutaneous nerve fibers, and free nerve endings. The clinical range of leprosy is determined by individual cell-mediated immune response to infection that also may play a role in different types of pain syndromes in leprosy. Previous studies reported a high prevalence of neuropathic pain in leprosy. In an Ethiopian study with 48 patients, pure nociceptive pain was experienced by 43% of patients and pure neuropathic pain (NeP) by 11% of patients. In an Indian study, 21.8% of leprosy patients had pain with neuropathic characteristics. These rates underlie the need to develop tools for the early diagnosis and detection of infection and its complications, such as nerve damage and pain. In a larger sample with leprosy-associated NeP (n = 90), we have applied the Douleur Neuropathique en 4 questions (DN4) and found sensitivity = 97.1% and specificity = 57.9%. The high sensitivity of this tool in leprosy patients suggests that it could be a valuable tool to screen for neuropathic pain in this population and could be used as part of health care programs aimed at detecting, treating, and rehabilitating leprosy in endemic areas.</p>
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