[Syringomyelic form of leprosy].

Area of Science:

• Neurology
• Infectious Diseases
• Dermatology

Background:

• Leprosy is a chronic infectious disease caused by Mycobacterium leprae.
• The disease primarily affects the skin, peripheral nerves, upper respiratory tract, eyes, and testes.
• Neurological manifestations of leprosy can be diverse and sometimes mimic other neurological conditions.

Observation:

• A 60-year-old man presented with recurrent painless burns and trophic ulcers on his hands.
• Initial neurological examination revealed decreased temperature and pain sensation in the upper extremities, with normal other sensory modalities.
• Despite initial suspicion of syringomyelia, imaging was negative. A year later, patchy anesthesia in all extremities was noted, leading to a diagnosis of leprosy.

Findings:

• Skin and nerve biopsies confirmed the diagnosis of leprosy.
• The patient exhibited a 'syringomyelic' pattern of sensory loss, characterized by patchy anesthesia.
• This presentation underscores the diagnostic challenge posed by the neurological variants of leprosy.

Implications:

• The syringomyelic form of leprosy can be misdiagnosed as intraspinal space-occupying lesions.
• In leprosy-endemic regions, unusual sensory disturbances like patchy dysesthesia warrant consideration of leprosy.
• Timely diagnosis and treatment are essential to prevent further nerve damage and disability.