Progression of leprosy neuropathy: a case series study

Area of Science:

• Neurology
• Infectious Diseases
• Clinical Neuroscience

Background:

• Leprosy neuropathy presents a significant clinical challenge, necessitating detailed characterization of nerve fiber function.
• Understanding the temporal evolution of nerve function impairment is crucial for effective management of leprosy patients.

Purpose of the Study:

• To evaluate the clinical and neurophysiological characteristics of leprosy neuropathy.
• To assess nerve function at diagnosis and one year post-multidrug therapy (MDT) in paucibacillary (PB) and multibacillary (MB) leprosy patients.
• To compare nerve function impairment between PB and MB leprosy patients.

Main Methods:

• Prospective clinical study involving 22 leprosy patients (10 PB, 12 MB).
• Peripheral nerve function assessed via clinical evaluation, sympathetic skin response, skin vasomotor reflex, and nerve conduction studies (NCS).
• Data collected at diagnosis and one year after cessation of MDT.

Main Results:

• At diagnosis, 73% of patients exhibited nerve function impairment (NFI).
• MB patients showed significantly greater autonomic dysfunction and altered NCS compared to PB patients at diagnosis (P<0.05).
• NFI worsened in MB patients post-treatment, particularly those experiencing leprosy reactions, while PB patients showed improvement, creating a significant difference between groups (P<0.001).

Conclusions:

• Newly diagnosed leprosy patients have a high prevalence of neuropathy.
• Combining various neurophysiological tests with clinical evaluation enhances neuropathy detection rates.
• Distinct patterns of nerve function impairment and recovery exist between PB and MB leprosy patients following MDT.