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Involvement Beyond Peripheral Nerves in Pure Neuritic Leprosy: An MR Imaging Study
Sanjeev Kumar Bhoi1, Suprava Naik2, Yuvraj Lahre3
1From the Department of Neurology (S.K.B., Y.L., M.J., P.S., P.B.), All India Institute of Medical Sciences, Bhubaneswar, Odisha, India sanjeev_bhoi@rediffmail.com.
AJNR. American Journal of Neuroradiology
|March 20, 2025
Summary
Pure neuritic leprosy (PNL) patients often show subclinical central nervous system (CNS) involvement. Magnetic resonance imaging (MRI) reveals abnormalities in the dorsal root ganglion, spinal cord, and plexuses, aiding early diagnosis.
Area of Science:
- Neurology
- Radiology
- Infectious Diseases
Background:
- Pure neuritic leprosy (PNL) primarily affects peripheral nerves.
- Central nervous system (CNS) involvement in leprosy is uncommon but documented.
- Previous studies suggest potential CNS changes in leprosy patients.
Purpose of the Study:
- To prospectively evaluate subclinical nervous system involvement beyond peripheral nerves in PNL patients.
- To assess the utility of Magnetic Resonance Imaging (MRI) in detecting CNS abnormalities in PNL.
- To correlate MRI findings with clinical and laboratory parameters.
Main Methods:
- Screening of patients with neuropathy and/or thickened nerves.
- Clinical examination, nerve conduction studies, and sural nerve biopsy for diagnosis.
- MRI of brachial/lumbar plexus, dorsal root ganglia, spinal cord, and brain in confirmed Hansen neuritis cases.
Main Results:
- 52 out of 86 screened patients had histopathologically confirmed PNL.
- Abnormal MRI findings were observed in 40.38% (21/52) of patients.
- Ganglionitis (26.92%), plexitis (15.38%), and myelitis (11.53%) were the most common MRI findings.
Conclusions:
- PNL patients frequently exhibit subclinical involvement of the dorsal root ganglion, spinal cord, and plexuses.
- MRI can aid in the early diagnosis and management of PNL complications.
- These findings underscore the importance of considering central nervous system imaging in PNL assessment.
