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Neurologic changes in visceral leishmaniasis
F A Hashim1, A E Ahmed, M el Hassan
1Leishmaniasis Research Group, National Research Council, Khartoun, Sudan.
The American Journal of Tropical Medicine and Hygiene
|February 1, 1995
Summary
Neurologic changes, including burning feet and hearing loss, affect nearly half of visceral leishmaniasis (VL) patients. Treatment of VL with anti-leishmanial drugs improved nerve function and hearing.
Area of Science:
- Neurology
- Infectious Diseases
- Parasitology
Background:
- Neurologic manifestations of visceral leishmaniasis (VL) are uncommon but can significantly impact patient health.
- Understanding these neurological complications is crucial for comprehensive patient management.
Purpose of the Study:
- To investigate the prevalence and nature of neurologic changes in patients with visceral leishmaniasis.
- To explore the underlying pathology and the effects of anti-leishmanial treatment on neurological recovery.
Main Methods:
- Clinical assessment of 111 visceral leishmaniasis patients for neurologic symptoms and signs.
- Nerve conduction studies, histopathology, and electron microscopy on nerve biopsies.
- Audiographic studies to evaluate hearing loss.
Main Results:
- 46% of VL patients exhibited neurologic symptoms, most commonly burning feet, foot drop, and deafness.
- Nerve conduction studies revealed axonal degeneration and demyelination without direct parasitic infection or neuritis.
- Sensory symptoms resolved quickly with anti-leishmanial treatment, while motor recovery was slower; hearing improved with sodium stibogluconate.
Conclusions:
- Neurologic complications are a significant, though rarely reported, feature of visceral leishmaniasis.
- The nerve pathology appears to be secondary to the infection, possibly immune-mediated, rather than direct invasion.
- Prompt anti-leishmanial treatment can lead to recovery of neurological function, particularly sensory symptoms and hearing.