Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature
Five years after both right ulnar and median nerve decompression for paraesthesias and palsy, a patient, coming from Nigeria but living in Italy, came to our unit claiming to have persistent pain and combined median and ulnar palsy. Under suspicion of leprosy, skin and left sural nerve biopsy were p...
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| Format: | Article |
| Language: | English |
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Wiley
2016-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2016/2767856 |
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| author | Michele R. Colonna Giuseppe Tallarida Francesco Stagno d’Alcontres Salvatore Noto Aurora Parodi Alberto Tagliafico |
| author_facet | Michele R. Colonna Giuseppe Tallarida Francesco Stagno d’Alcontres Salvatore Noto Aurora Parodi Alberto Tagliafico |
| author_sort | Michele R. Colonna |
| collection | DOAJ |
| description | Five years after both right ulnar and median nerve decompression for paraesthesias and palsy, a patient, coming from Nigeria but living in Italy, came to our unit claiming to have persistent pain and combined median and ulnar palsy. Under suspicion of leprosy, skin and left sural nerve biopsy were performed. Skin tests were negative, but Schwann cells resulted as positive for acid-fast bacilli (AFB), leading to the diagnosis of Pure Neuritic Leprosy (PNL). The patient was given PB multidrug therapy and recovered from pain in two months. After nine months both High Resolution Ultrasonography (HRUS) and Magnetic Resonance Imaging (MRI) were performed, revealing thickening of the nerves. Since demyelination is common in PNL, the Authors started to use Diffusion Tensor Imaging Tractography (DTIT) to get better morphological and functional data about myelination than does the traditional imaging. DTIT proved successful in showing myelin discontinuity, reorganization, and myelination, and the Authors suggest that it can give more information about the evolution of the disease, as well as further indications for surgery (nerve decompression, nerve transfers, and babysitting for distal effector protection), and should be added to traditional imaging tools in leprosy. |
| format | Article |
| id | doaj-art-56630e47264a45ffb83fcb647ba36251 |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2016-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-56630e47264a45ffb83fcb647ba362512025-02-03T01:11:12ZengWileyCase Reports in Neurological Medicine2090-66682090-66762016-01-01201610.1155/2016/27678562767856Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the LiteratureMichele R. Colonna0Giuseppe Tallarida1Francesco Stagno d’Alcontres2Salvatore Noto3Aurora Parodi4Alberto Tagliafico5Plastic Surgery, Department of Human Pathology, University of Messina, Messina, ItalyPlastic Surgery, University of Messina, Messina, ItalyPlastic Surgery, Department of Human Pathology, University of Messina, Messina, ItalyPrivate Dermatology Practice, Bergamo, ItalyDepartment of Health Sciences, University of Genoa, Genoa, ItalyDepartment of Experimental Medicine, University of Genoa, Genoa, ItalyFive years after both right ulnar and median nerve decompression for paraesthesias and palsy, a patient, coming from Nigeria but living in Italy, came to our unit claiming to have persistent pain and combined median and ulnar palsy. Under suspicion of leprosy, skin and left sural nerve biopsy were performed. Skin tests were negative, but Schwann cells resulted as positive for acid-fast bacilli (AFB), leading to the diagnosis of Pure Neuritic Leprosy (PNL). The patient was given PB multidrug therapy and recovered from pain in two months. After nine months both High Resolution Ultrasonography (HRUS) and Magnetic Resonance Imaging (MRI) were performed, revealing thickening of the nerves. Since demyelination is common in PNL, the Authors started to use Diffusion Tensor Imaging Tractography (DTIT) to get better morphological and functional data about myelination than does the traditional imaging. DTIT proved successful in showing myelin discontinuity, reorganization, and myelination, and the Authors suggest that it can give more information about the evolution of the disease, as well as further indications for surgery (nerve decompression, nerve transfers, and babysitting for distal effector protection), and should be added to traditional imaging tools in leprosy.http://dx.doi.org/10.1155/2016/2767856 |
| spellingShingle | Michele R. Colonna Giuseppe Tallarida Francesco Stagno d’Alcontres Salvatore Noto Aurora Parodi Alberto Tagliafico Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature Case Reports in Neurological Medicine |
| title | Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature |
| title_full | Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature |
| title_fullStr | Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature |
| title_full_unstemmed | Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature |
| title_short | Diffusion Tensor Imaging Tractography in Pure Neuritic Leprosy: First Experience Report and Review of the Literature |
| title_sort | diffusion tensor imaging tractography in pure neuritic leprosy first experience report and review of the literature |
| url | http://dx.doi.org/10.1155/2016/2767856 |
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