The clinical & neurophysiological study of leprosy

Objectives: The aim of this study was to evaluate neurological and neurophysiological features of leprosy.

Methods: Seventy seven hospitalized leprosy patients (52 male, 25 female) were examined neurological and neurophysiologically between 2010 and 2012. Standard procedures were performed for evaluating sensory and motor conduction studies to all patients. Motor studies were carried out on median, ulnar, tibial and common peroneal nerves. Sensory studies were carried out on median, ulnar and sural nerves. Sympathetic skin response (SSR) recordings on both hands and feet, and the heart rate (R-R) interval variation (RRIV) recordings on precordial region were done in order to evaluate the autonomic dysfunction.

Results: The mean age was 59.11±14.95 years ranging between 17 and 80 years. The mean duration of disease was 35.58±18.30 years. Clinically, the patients had severe deformity and disability. In neurophysiological examinations, sensory, motor conduction studies of the lower extremities were found to be more severely affected than upper, and sensory impairment predominated over motor. Abnormal SSRs were recorded in 63 (81.8%) cases of leprosy. Abnormal RRIVs were recorded in 41 (53.2%) cases and abnormal RRIVs with hyperventilation were recorded in 55 (71.4%) cases of leprosy. Significant differences were found between SSR and sensory conduction parameters of median, ulnar nerves as well as motor conduction parameters of median, ulnar and peroneal nerves (p < 0.05).

Conclusion: Peripheral nervous system dysfunction is accompanied by autonomic nervous system dysfunction in leprosy patients. Sympathetic involvement may predominate over parasympathetic involvement.