Isolated median neuropathy as the first symptom of leprosy

• Published in: Muscle & nerve 2013-08, Vol.48 (2), p.179-184
• Main Authors: Vital, Robson Teixeira, Illarramendi, Ximena, Antunes, Sérgio Luiz Gomes, Nascimento, Márcio, Da Costa Nery, José Augusto, Nascimento, Osvaldo, Sarno, Euzenir Nunes, Jardim, Márcia Rodrigues
• Format: Article
• Language: English
• Subjects: Adult; bone resorption; digital neuropathy; Electromyography; Evoked Potentials, Motor - physiology; Female; Humans; leprosy; Leprosy - physiopathology; Male; median neuropathy; Median Neuropathy - pathology; Median Neuropathy - physiopathology; median neuropathy, nerve biopsy; Medical research; Middle Aged; nerve biopsy; Pain Measurement; Peripheral Nerves - pathology; Peripheral Nerves - physiopathology; pure neural leprosy; Skin - pathology; Wrist - innervation; Young Adult
• ISSN: 0148-639X; 1097-4598
• DOI: 10.1002/mus.23731

ABSTRACT Introduction Focal peripheral neuropathy of the median nerve is mainly caused by a traumatic event or pressure, but it may also be produced by systemic illnesses. Among the latter, leprosy is a rare cause. Methods Six cases of isolated median neuropathy as the first sign of leprosy were selected from patients with an exclusively neurological complaint as the initial symptom. The patients, evaluated at the National Leprosy Reference Center in Rio de Janeiro, Brazil, followed routine and specialized procedures. Results Three of the patients had pure neural leprosy, and 3 had skin lesions. Clinical median nerve function impairment was confirmed by neurophysiological testing and histopathology. Both mononeuritis and mononeuritis multiplex were observed. Conclusions This case series demonstrates an additional form of presentation of leprosy, which, if not diagnosed and treated in time, may lead to permanent disability. Muscle Nerve, 48: 179–184, 2013