Background: Nerve damage in leprosy reaction occurs very quickly, that can lead to paralysis for many peripheral nerves within 24 hours. Objective: To survey nerve function impairment in leprosy reactions. Subjects and method: 285 new leprosy patients treated from 1996 to 2000 at 22 districts in Ho Chi Minh city had leprosy reaction and estimated nerve functions. This was retrospective cross-section descriptive study. Results: This study included 70.2% men, age 15-45 years (71.9%) and most patients were manual laborers. There were 83.5% multibacillary (MB) and 16.5% paucibacillary (PB). 86.3% Reversal Reaction (RR), Erythemal Nodosum Leprosy (ENL) 13% and both 0.7%. 53% of leprosy reaction happened during Multi-Drug Treatment (MDT), at diagnosis 37.5%, before MDT 7.7% and after MDT 1.8%. Nerve function impairment was 38.2% in leprosy reaction; men had impaired nerve function 1.7 times higher than women (p<0.05). Nerve function impairment in RR and ENL as well as MB and PB were the same (p>0.05). MB (42%) has impaired nerve function higher than PB (26.1%) in RR (p<0.05, OR = 2.05). Conclusions: Leprosy reaction happened to men more frequent than women, essentially in MB and during MDT. One third of cases had nerve function impairment in leprosy reaction and also had a link between sex and nerve function impairment. MB was 2 times the impaired nerve function higher than PB in RR.
Nerve function impairment ; leprosy reaction

White matter hyperintensity (WMH) is commonly observed on the brain MRI of elderly subjects. It has been considered as an important biomarker for the micro-vascular damages of white matter of the brain. Aging, hypertension, diabetes mellitus, and hyperhomocysteinemia have been associated with WMH development. WMH is an important risk factor for the vascular dementia (VD), however it also considered as one of risk factors for conversion of mild cognitive impairment to dementia and progression of Alzheimer's disease (AD). WMH has impact on gait, bladder control, and fine motor coordination. It also has negative effects on memory retrieval, mental flexibility, mental processing speed, and executive function by disconnecting nerve fibers that convey signals for normal cognition. Control of vascular risk factors can delay progression of WMH and this may be beneficial for VD as well as AD with ischemic changes, especially in the early state of diseases. In this paper, we will review clinical significance of WMH and three important diseases, subcortical vascular dementia, cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy, and cerebral amyloid angiopathy that associated with cerebral micro-vascular damages.
Aged ; Aging ; Alzheimer Disease ; Brain ; CADASIL ; Cerebral Amyloid Angiopathy ; Cognition ; Dementia ; Dementia, Vascular ; Diabetes Mellitus ; Executive Function ; Gait ; Humans ; Hyperhomocysteinemia ; Hypertension ; Memory ; Mild Cognitive Impairment ; Nerve Fibers ; Pliability ; Risk Factors ; Urinary Bladder