Clinical and Electrophysiological Characteristics of Leprous Neuropathy

Background: It is important to consider leprosy as a cause of peripheral neuropathy, as it is readily treatable. We analyzed clinical and electrodiagnostic characteristics of leprosy patients with peripheral nerve involvement. Methods: This study was a retrospective analysis of nerve conduction studies (NCS) and the medical records of 10 patients with leprosy were confirmed by a skin or nerve biopsy. NCS using a conventional surface technique were performed in 15 upper extremities and 14 lower extremities. Results: Among ten patients, three patients presented with mononeuropathy, and the others with mononeuropathy multiplex. Five patients had medical histories of leprosy treatment. The patterns of peripheral neuropathies were mononeuropathy multiplex except for one who had an ulnar mononeuropathy. On motor NCS, low or absent CMAPs were most common abnormalities followed by slow conduction velocity and prolonged terminal latency. Sensory NCS also showed changes of amplitudes rather than in conduction velocity. The conduction block of CMAPs with or without dispersion were observed in 5 patients usually on the ulnar nerve at the forearm. Conclusions: In most instances, leprous patients with neuropathy presented with mononeuropathy multiplex affecting the sensory and motor nerves. NCS showed more likely axonal than demyelinating changes, but the conduction blocks were also found frequently at the forearms. J Korean Neurol Assoc 25(2):194-198, 2007