[Leprous neuropathies]

The damage to the peripheral nervous system (PNS) is a marker of Micobacterium leprae (M. leprae) infection that develops as a result of the M. leprae invasion to the Schwann cells. Clinical, functional (skin-deep and stimulating electromyography, determination of the spreading velocity of the pulsatory wave along the arteries of muscle type, direct and volumetric sphingmography, reovasography, skinning electrotermometry) and immunological (evaluation of antibodies to neuroantigenes by ELISA) methods were used to study 132 patients with leprous neuropathy. Sensory impairment (descend of superficial sensibility, combination of the spotted, trunk and polyneuritic types of sensory injury), hypertrophy of the peripheral nerves and their painfulness by palpation were shown to develop at the initial stage, with the following joining of motor and trophic disturbances, such as amyotrophy, contractures, shortening of digits, trophic ulcer. Skin-deep and stimulating electromyography revealed the subclinical manifestation of neuromuscular system injuries in clinically normal muscles. A neuroantigen's entrance into the bloodstream and antibody reactions to them were characteristic of LN. High antibody levels, as a rule, corresponded to the exacerbations of leprous neuropathy, activation of leprous process, relapses of the disease and reactions of leprous erythema nodosum type. An association between specific humoral response to the antigens of the M. leprae and production of the antibodies to neuromarkers was found.