Autonomic nerve affection in leprosy

Leprosy has been shown to affect almost all systems of human body and abnormalities in functions of autonomic nerves innervating various parts have been observed in several studies. In the skin and its appendages, the common changes are anhidrosis and varying degree of impaired sweat response. Signs of denervation of iris and reduced intraocular pressure are permanent features of autonomic involvement in the eye. In the cardiac autonomic functions, rhythm disturbances have been documented by several investigators. Respiratory function test studies have shown impaired breath holding time and decreased response to cough as well as other changes indicating blockade of vagus nerves and sympathetic plexus. Abnormal testicular pain sensation and diminished nocturnal penile tumiscence provide evidence of afflication of autonomic nerves of male genital system. Other important autonomic nervous system involvements include the nerves innervating the capillaries of legs. These changes have been observed to be more in extensive and long standing disease which indicate the need to study all these aspects in prospective studies specially in the light of early institution of multidrug treatment.