Leprosy Training Module for Medical Officers

Method for testing anaesthesia :
First, explain to the patient what you will be doing and how you will
be doing it.
Then, keeping his eyes open, touch on the normal skin of the forehead,
neck and hands, which perceive any sensation the better than any other part
of the body.
The patient now will be able to perceive the touch sensation. Now, ask
the patient to close his eyes. Then, first touch the same normal skin spots
and ask him to indicate the exact points. After this, he will be able to
perceive the touch sensation fully even with his eyes closed.
Now, having his eyes still closed, examine the patch for anaesthesia.
Ask him to indicate the exact location of the point, where the feather has
been touched. Failure to do so shows anaesthesia on the spot.
Note : If he feels it but cannot touch the exact point, it is called misreference,
and this is the earliest sign of anaesthesia.
The normal range of accuracy of his indication of the point
- on the hand is within 1 cm.
- on the face is 2 cm.
- on the back and buttocks is 7 cm.
Remember :
1. The innervation of the face is from multiple sources so that it is not often
anaesthetic.
2. Always proceed from normal skin to abnormal.
3. Give only one stimulus at a time.
4. Vary the pace of testing.
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