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Multiple cranial neuropathies associated with leprosy

J T Paul1, K North-Wilhelm, G A Higdon

  • 1Department of Family Practice, Martin Army Community Hospital, Ft. Benning, Ga.

Southern Medical Journal
|September 1, 1994
PubMed
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This case study details an unusual presentation of leprosy in a Samoan man, highlighting multiple cranial nerve involvements. The findings underscore the diverse neurological manifestations of this infectious disease.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Dermatology

Background:

  • Leprosy, a chronic infectious disease caused by Mycobacterium leprae, can present with diverse clinical manifestations.
  • Neurological complications are common in leprosy, but extensive cranial neuropathies are less frequently reported.

Observation:

  • A Samoan man presented with dysphagia, voice hoarseness, facial erythema, and edema.
  • Neurologic examination revealed facial sensory loss, enlarged auricular nerves, facial palsy, diminished gag reflexes, and vocal cord paralysis.
  • Laryngoscopy confirmed left vocal cord paralysis, and barium swallow suggested a compressive lesion.

Findings:

  • Skin biopsy confirmed tuberculoid leprosy.
  • The patient exhibited multiple cranial neuropathies, an atypical presentation for leprosy.

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  • This case highlights the potential for leprosy to affect numerous cranial nerves simultaneously.

    • Implications:

    • This case expands the understanding of leprosy's neurological spectrum.
    • It emphasizes the importance of considering leprosy in patients with unexplained cranial neuropathies, especially in endemic regions.
    • Further research into the pathogenesis of multiple cranial nerve involvement in leprosy is warranted.