Neurological Complications of Leprosy

Abstract

Leprosy is a challenging international health concern. Despite tremendous efforts in reducing worldwide disease prevalence in the past decades, some countries remain endemic and are plagued by high levels of disability. The neurological complications of leprosy are varied and complex, with current research focused on evaluating tools for earlier diagnosis of neuropathy, especially in resource-limited countries. While treatment with multidrug therapy is highly effective, active research aims to simplify regimens to improve adherence, minimize adverse effects, and prevent antimicrobial resistance. Although promising progress has been made in the past decades, further efforts are needed to push the international community toward achieving worldwide elimination.

Infections of the Peripheral Nervous System

“…to 10% of patients with leprosy-associated neuropathy, so the absence of dermatologic findings does not exclude the diagnosis. 35 Anesthesia may be present within a skin lesion. The organism commonly infiltrates the face causing a variety of classic features including thickened skin, exaggeration of skin folds, loss of eyebrows, and saddle nose.…”

“…The Ridley-Jopling system uses a combination of clinical findings, histopathology, and bacterial load to place patients within one of five categories covering the spectrum of disease. Those with preserved cellular immune response fall within the category of tuberculoid leprosy on one end of the spectrum, whereas those with poor cellular immune response fall within the lepromatous leprosy category on the opposite end of the spectrum 35 . The WHO classification is simpler, being divided into paucibacillary (roughly correlates to tuberculoid leprosy ) and multibacillary disease (correlates to lepromatous leprosy ) based on the number of skin lesions or skin smear findings.…”

El gran imitador: revisión bibliográfica de la lepra

“…La manifestación neurológica más comúnmente descrita es la mononeuropatía múltiple, que ocurre en un 95% de los casos. Como anteriormente se ha citado, el compromiso neurológico es dependiente de la temperatura, afectando nervios como el ulnar, mediano, peroneal, poplíteo lateral y tibial posterior que coinciden con zonas más frías del cuerpo (13). Además, puede llegar a comprometer nervios craneales como el nervio Trigémino y Facial.…”

“…Los hallazgos clínicos son diversos y varían desde anestesia, debilidad extrema hasta úlceras y deformidades, asimismo pueden sufrir disfunción autonómica como por ejemplo anhidrosis y alopecia. Estos se pueden manifestar como episodios agudos que interrumpen un episodio crónico de neuropatía (13).…”

Peripheral Neuropathy in Leprosy: Clinical Manifestations and Disability in a Colombian National Referral Center

“…The ulnar, common peroneal, radial, posterior tibial, median and supraorbital nerves are the main nerves involved. [7][8][9][10][11] The spectrum of leprosy most associated with physical deformities is borderline leprosy, which leads to abrupt changes in the immune system that lead to a rapid involvement of various nerve trunks. Periodic clinical evaluation is essential in these patients, as well as the assessment of the level of disability at the time of diagnosis, which is carried out based on a standardized classification by the WHO.…”