Role of surgical decompression in ulnar neuritis of leprosy

The present study was undertaken to evaluate the effect of neurolysis in relieving the pain of acute painful neuritis and assess its effect on the sensory motor deficit. Thirty eight ulnar nerves were operated and followed up for 8 to 125 weeks. Following surgery relief from pain was gratifying. However the pain recurred in cases of lepromatous leprosy in subsequent episodes of ENL reaction. Sensory recovery was appreciable and occurred within 8 weeks. Four cases had 75% recovery; five had 50 to 75% recovery and 11 cases had up to 50% recovery. Motor recovery took a longer time to appear. Proximal supplied muscles recovered first followed by smaller muscles. In most cases further deterioration of muscle power was prevented. Only 3 cases deteriorated. Recovery was more pronounced in LL cases. Patients with shorter duration of acute symptoms and history of smaller number of attacks of acute painful neuritis showed a higher incidence and better grade of recovery.