[Clinical aspects of leprous neuropathy]

For the last 5 years, not a single new case of leprosy has been reported among native Japanese people, but several new cases of leprosy have been reported every year among foreigners in Japan. Because most leprosy patients consult doctors not for skin rashes but for the neurological symptoms of leprous neuropathy, every neurologist should be well aware of the clinical features of leprous neuropathy. The finding that the clinical pictures of leprous neuropathy differ greatly between patients from the main Japanese islands and those from Okinawa is of clinical importance the former comprise the lepromatous type while the latter are of the borderline group. The clinical features of leprous neuropathy among people from leprosy-prone areas in the world wide are usually of the tuberculoid type or of the borderline group. Further, the clinical pictures of each type of leprous neuropathy are so distinct that these conditions can be diagnosed with the simple classical neurological examination. One of the most important issues in managing leprosy patients with neurological deficits is protection of the areas of analgesia caused by leprous neuropathy from injuries or burns. Protection against entrapment neuropathies of thickened peripheral nerve trunks, which are quite likely to be compressed during various activities of daily living, is also important.