Shall we continue with nerve trunk decompression in leprosy?

Abstract

There is a tendency to compare the results of surgery with that of oral corticosteroid therapy in leprous neuritis as if the two are competing methods. Surgery helps by removing the external compressive force and improves circulation so that steroids can reach and effectively act at the site of inflammation, minimizing the ischaemic and compression damage to nerve fibres. Often nerve decompression in leprosy is requested rather late so that the desired results are not always achieved. With emphasis on "elimination of leprosy", the disease is being managed in endemic states by field programmes where individual patient is not the priority unlike in the general hospitals and among practitioners where the welfare of the patient is the priority. It is therefore important to create awareness about compression neuropathy in leprosy and the need for combination therapy so as to bring down the morbidity and disability.