Patients and Methods Twenty-two leprosy patients (16 men and six women, aged 19–60) diagnosed at the Leprosy Outpatient Clinic, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil, were

evaluated prior to and one year after cessation of MDT and consecutively selected regardless of their neurological condition. Patients with associated diseases such as diabetes mellitus, alcoholism, Human immunodeficiency virus or Human T-linphotrofic virus-I infections, rheumatoid/rheumatic Inhibitors,research,lifescience,medical diseases, or with toxic, drug-induced, or hereditary neuropathies were excluded. All patients received MDT: PB patients with no observable bacilli in six slit-skin smears (baciloscopic index = 0) were treated for six months with one supervised monthly dose of 600 mg rifampicin and 100 mg dapsone in conjunction with 100 mg/day dapsone; MB patients with positive

slit-skin smears to M. leprae, received a monthly supervised dose of 600 mg rifampicin, 100 Inhibitors,research,lifescience,medical mg dapsone, and 300 mg clofazimine together with 100 mg/day dapsone and 50 mg/day clofazimine for 12 months. Upon completion of MDT, the patients were directed to return in the case of the development of new lesions, the worsening of old ones, or the appearance of neurological symptoms. The research was carried out in compliance with the International Norms on Ethics in Human Research, having been previously approved Inhibitors,research,lifescience,medical by the Ethics Committee of the Oswaldo Cruz Foundation. All patients voluntarily provided their written, informed Inhibitors,research,lifescience,medical consent. A clinical neurological evaluation of the peripheral nerves of all patients was performed. LNF were complementarily evaluated by means of NCS and autonomic function via SVMR and SSR. The evaluations at diagnosis and one year after cessation of MDT were performed by different neurologists. A detailed neurologic examination was performed to record the number and distribution of affected nerves. The analyzed components of the neurologic examination were: motor strength Inhibitors,research,lifescience,medical and tactile sensation for LNF evaluation, thermal and pain sensation, presence of cyanosis on the palms and/or soles, and paraesthesia for the small nerve fiber

(SNF) evaluation. Sensory impairment, motor deficit, and disability/deformity status were assessed using standard much methods. In brief, tactile threshold was tested with Semmes-Weinstein monofilaments. The learn more monofilaments vary in thickness, with a different value in grams for each one (1 = 300 g, 2 = 4 g, 3 = 2 g, 4 = 0.2 g, and 5 = 0.05 g), and the inability to perceive the touch of even one of them represents an absence of tactile sensitivity to that given pressure (Ministério da Saúde 2001, 2002). Thermal sensation was determined by the use of cold metal (15°C cold) objects, and a safety pin was utilized to ascertain pain perception in the median, ulnar, radial, sural, superficial fibular, and plantar bilaterally nerves.