Nerve damage in leprosy: An electrophysiological evaluation of ulnar and median nerves in patients with clinical neural deficits: A pilot study

Abstract

Background:Leprosy involves peripheral nerves sooner or later in the course of the disease leading to gross deformities and disabilities. Sadly, by the time it becomes clinically apparent, the nerve damage is already quite advanced. However, if the preclinical damage is detected early in the course of disease, it can be prevented to a large extent.Materials and Methods:We conducted an electrophysiological pilot study on 10 patients with clinically manifest leprosy, in the Dermatology Department of Mahatma Gandhi Institute of Medical Sciences, Sewagram. This study was done to assess the nerve conduction velocity, amplitude and latency of ulnar and median nerves.Results and Conclusion:We found reduced conduction velocities besides changes in latency and amplitude in the affected nerves. Changes in sensory nerve conduction were more pronounced. Also, sensory latencies and amplitude changes were more severe than motor latencies and amplitude in those presenting with muscle palsies. However, further studies are going on to identify parameters to detect early nerve damage in leprosy.

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“…Present study showed marked changes in all nerve conduction parameters in median and ulnar nerves which are suggestive of mixed axonal-demyelinating type of neural damage of both sensory and motor fibres. Similar findings were observed by Kar et al, Maharatta et al, Chaurasia et al, Husain et al 1,2,5,9,11 There are certain causes for the occurrence of multiple changes in NCS, even in newly diagnosed cases at our center, viz. prevalent illiteracy among study population and attached social stigma with the disease, making the presentation late.…”

“…Peripheral neuropathy in leprosy varies from as small as, involvement of an intradermal nerve in the cutaneous patches to as large as major lesion in the peripheral or cranial nerve trunk. 1 This silent neuropathy starts with blockade of nerve impulse and then leads to visible pathological changes. 2 Cranial nerve involvement like facial, trigeminal or other nerves is also commonly seen in patients with leprosy.…”

Clinical-Epidemiological Profile Of Patients Living With Leprosy

“…Serious injury may occur in the peripheral nerves of leprosy patients, including sensory and motor disturbances and deformities [18]. However, in our study, lesions were not observed in peripheral nerves, as supported by data on the use of adaptation and disability level ( Table 2).…”

Distinção clínico-eletrofisiológica entre a neuropatia hereditária com suscetibilidade à pressão e a neuropatia hansênica

“…Potenciais near-nerve captados de fibras de seis micrômetros de diâmetro podem estar anormais quando o estudo da condução convencional está normal (MARQUES et al, 2003). Envolvimento do sistema autonômico pode ser documentado em pacientes com a forma virchoviana pela medida da resposta simpática da pele e medidas da frequência cardíaca durante a respiração profunda (BROWN et al, 1996b MOUTON et al, 1999) e da hanseníase (JARDIM et al, 2003;KAR et al, 2013;SANTOS et al, 2017). A mononeuropatia múltipla é um tipo de neuropatia periférica que compromete mais de um tronco nervoso com distribuição temporal e topográfica não uniforme.…”

“…33% e apenas três pacientes com polineuropatia como a forma clínica Kar et al (2013). relataram esse padrão em oito dos dez pacientes avaliados e dois pacientes com padrão de polineuropatia Jardim et al (2004).…”