Highlights
- •Leprosy is a common cause of neuropathy the world over with protean manifestations.
- •It may be mistaken for vasculitic, granulomatous and other rheumatologic disorders.
- •Patients may have positive sensory symptoms and lack trophic ulcers/thickened nerves.
- •Impaired kinaesthesia and variable stretch reflexes may mislead clinicians.
- •Awareness of uncommon features is essential for timely diagnosis and management.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Ancient skeletal evidence for leprosy in India (2000 B.C.).PLoS One. 2009; 4: e5669
- Therapeutic effects of adding rimactane (rifampicin) 450 milligrams daily or 1200 milligrams once monthly in a single dose to dapsone 50 milligrams daily in patients with lepromatous leprosy.Int. J. Lepr. Other Mycobact. Dis. 1979; 47: 37-43
- Once-monthly rifampicin plus daily dapsone in initial treatment of lepromatous leprosy.Lancet. 1982; 1: 1199-1202
- World Health Organization Technical Report Series. 874. 1998: 1-43
- The continuing challenges of leprosy.Clin. Microbiol. Rev. 2006; 19: 338-381
- Leprosy.Lancet. 2004; 363: 1209-1219
- Hazards of setting targets to eliminate disease: lessons from the leprosy elimination campaign.Br. Med. J. 2014; 348: g1136
- Leprous neuropathy.in: Said G. Krarup C. Handbook of Clinical Neurology. Peripheral Nerve Disorders. 115. Elsevier B.V., 2013: 499-514
- Elimination of leprosy & possibility of eradication — the Indian scenario.Indian J. Med. Res. 2012; 135: 3-5
- Diagnostic value of cardinal signs/symptoms in paucibacillary leprosy.Indian J. Lepr. 1988; 60: 207-214
- Neurological manifestations of Hansen's disease and their management.Clin. Neurol. Neurosurg. 2005; 107: 445-454
- The clinical and immunological features of leprosy.Br. Med. Bull. 2006; 77–78: 103-121
- Effect of Mycobacterium leprae in peripheral nerve trunk on the evolution of skin lesions.Int. J. Lepr. Other Mycobact. Dis. 1994; 62: 99-107
- Leprosy neuropathy: clinical presentations.Arq. Neuropsiquiatr. 2013; 71: 661-666
- A clinico-pathological study of primary neuritic leprosy.Lepr. India. 1983; 55: 212-221
- Neuritic leprosy: further progression and significance.Acta Leprol. 1995; 9: 187-194
- The diagnosis of leprosy is delayed in the United Kingdom.Q. J. Med. 2001; 94: 207-212
- Rabies, Tetanus, Leprosy, and Malaria.in: Biller J. Ferro J.M. Handbook of Clinical Neurology. 1st ed. Neurologic Aspects of Systemic Disease Part III. 121. Elsevier B.V., 2014: 1501-1520
- The biology of nerve injury in leprosy.Lepr. Rev. 2008; 79: 242-253
- Nerve damage in leprosy: a continuing challenge to scientists, clinicians and service providers.Int. Health. 2012; 4: 77-85
- Early diagnosis of neuropathy in leprosy—comparing diagnostic tests in a large prospective study (the INFIR cohort study).PLoS Negl. Trop. Dis. 2008; 2: e212
- Leprous neuritis: a diagnostic dilemma.Indian J. Dermatol. Venereol. Leprol. 1999; 65: 59-65
- Molecular basis for the peripheral nerve predilection of Mycobacterium leprae.Curr. Opin. Microbiol. 2001; 4: 21-27
- ErbB2 receptor tyrosine kinase signaling mediates early demyelination induced by leprosy bacilli.Nat. Med. 2006; 12: 961-966
- Challenges presented by nerve damage in leprosy.Lepr. Rev. 2005; 76: 5-13
- Pure neuritic leprosy in India: an appraisal.Int. J. Lepr. Other Mycobact. Dis. 2004; 72: 284-290
- “Jhum-jhum”—a common paraesthesia in leprosy.Lepr. Rev. 2001; 72: 100-101
- Chronic neuropathic pain in treated leprosy.Lancet. 2000; 356: 1080-1081
- Primary neuritic leprosy: a reappraisal at a tertiary care hospital.Indian J. Lepr. 2006; 78: 261-267
- Neuropathic pain in leprosy.Lepr. Rev. 2004; 75: 7-18
- Leprosy late-onset neuropathy: an uncommon presentation of leprosy.Arq. Neuropsiquiatr. 2012; 70: 404-406
- Investigation of neuropathic pain in treated leprosy patients in Ethiopia: a cross-sectional study.Pain. 2012; 153: 1620-1624
- Painful peripheral neuropathies.Curr. Neuropharmacol. 2006; 4: 175-181
- The INFIR Cohort Study: investigating prediction, detection and pathogenesis of neuropathy and reactions in leprosy. Methods and baseline results of a cohort of multibacillary leprosy patients in north India.Lepr. Rev. 2005; 76: 14-34
- Proprioceptive loss in leprous neuropathy: a study of 19 patients.Neurol. India. 2008; 56: 450
- Pseudoathetosis in a patient with leprosy.Mov. Disord. 2003; 18: 598-601
- Severe pan-sensory neuropathy in leprosy.Int. J. Lepr. Other Mycobact. Dis. 1994; 62: 24-31
- Spinal cord involvement and ganglionitis in leprosy.Neurol. India. 2007; 55: 427-428
- Perspectives in pathology of leprosy.Indian J. Med. Sci. 1955; 9: 1-52
- Sensory neuron diseases.Lancet Neurol. 2005; 4: 349-361
- Leprosy and peripheral neuropathy.J. Clin. Neuromuscul. Dis. 2004; 5: 138-145
- Progression of leprosy neuropathy: a case series study.Brain Behav. 2012; 2: 249-255
- Inter-observer reliability in assessment of sensation of skin lesion and enlargement of peripheral nerves in leprosy patients.Lepr. Rev. 2006; 77: 371-376
- Sensitivity and specificity of nerve palpation, monofilament testing and voluntary muscle testing in detecting peripheral nerve abnormality, using nerve conduction studies as gold standard; a study in 357 patients.Lepr. Rev. 2009; 80: 34-50
- Enlarged peripheral nerves.Pract. Neurol. 2003; 3: 40-45
- A practical approach to enlargement of nerves, plexuses and roots.Pract. Neurol. 2015; 15: 105-115
- Thickened nerves in diagnosis of leprosy.Lepr. India. 1980; 52: 1-2
- The greater auricular nerve in presumably non-leprous British soldiers.Trans. R. Soc. Trop. Med. Hyg. 1980; 74: 136
- Neuropathic pain: redefinition and a grading system for clinical and research purposes.Neurology. 2008; 70: 1630-1635
- Newer management options in leprosy.Indian J. Dermatol. 2013; 58: 6-11
- Cranial neuropathy in patients with leprosy.Neurol. India. 2006; 54: 248-249
- Cranial nerve involvement in patients with leprous neuropathy.Neurol. India. 2006; 54: 283
- Oro-facial manifestations of 100 leprosy patients.Med. Oral Patol. Oral Cir. Bucal. 2012; 17: e728-e732
- Facial sensory loss in multi-bacillary leprosy patients.Lepr. Rev. 2013; 84: 194-198
- Facial burning in women with leprosy, physiological or pathological?.Ethiop. Med. J. 2007; 45: 35-41
- Cranial nerve involvement in leprosy.Indian J. Lepr. 2005; 77: 177-178
- Multiple cranial neuropathies associated with leprosy.South. Med. J. 1994; 87: 937-940
- Facial, glossopharyngeal, vagus and hypoglossal nerve palsy in a case of lepromatous leprosy.Indian J. Lepr. 1993; 65: 333-336
- Eighth nerve evaluation in leprosy.Indian J. Lepr. 1987; 59: 20-25
- Audiovestibular system, fifth and seventh cranial nerve involvement in leprosy.Indian J. Lepr. 1994; 66: 421-428
- Analysis of newly detected leprosy cases and misdiagnosis in Wuhan (1990–2004).Lepr. Rev. 2009; 80: 410-415
- Leprosy: a disease with diagnostic and management challenges!.Indian J. Dermatol. Venereol. Leprol. 2009; 75: 111-115
- A comparison of sensory loss tests and histopathology in the diagnosis of leprosy.Lepr. Rev. 1989; 60: 20-27
- Report of the International Leprosy Association Technical Foum. 25–28 February 2002. Paris, France.Lepr. Rev. 2002; 73 (Suppl.): S3-S61
- Which physical signs help most in the diagnosis of leprosy? A proposal based on experience in the AMFES project, ALERT, Ethiopia.Lepr. Rev. 2000; 71: 34-42
- Immune zones in leprosy.Indian J. Dermatol. 2009; 54: 206-210
- Clinico-pathological study of so-called immune zones in leprosy.Lepr. India. 1982; 54: 256-262
- Histopathologic study of clinically normal appearing skin in lepromatous leprosy.Lepr. India. 1979; 51: 78-80
- Infectious neuropathies.Curr. Opin. Neurol. 2013; 26: 510-515
- Histological studies in primary neuritic leprosy: changes in the apparently normal skin.Lepr. Rev. 1998; 69: 351-357
- Rheumatoid vasculitis: experience with 13 patients and review of the literature.Semin. Arthritis Rheum. 1985; 14: 280-286
- Leprosy in a rheumatology setting: a challenging mimic to expose.Clin. Rheumatol. 2013; 32: 1557-1563
- Synovial swellings over wrist in leprosy.Indian J. Lepr. 1985; 57: 350-353
- Study of rheumatic manifestations and serologic abnormalities in patients with lepromatous leprosy.J. Rheumatol. 1985; 12: 738-741
- The rheumatic manifestations of leprosy.Clin. Rheumatol. 1991; 10: 274-276
- Arthritis in leprosy.Rheumatology (Oxford). 2010; 49: 2237-2242
- A study of rheumatological manifestations of leprosy.Indian J. Dermatol. Venereol. Leprol. 2004; 70: 76-78
- Leprosy-related joint involvement.Clin. Rheumatol. 2009; 28: 79-84
- Autoantibodies in leprosy patients, with and without joint involvement, in the state of Amazonas.Rev. Bras. Reumatol. 2009; 49: 547-561
- The limited spectrum of antinuclear antibodies in leprosy.J. Rheumatol. 1987; 14: 108-110
- Increased incidence of cytoplasmic ANCA (cANCA) and other autoantibodies in leprosy patients from western India.Lepr. Rev. 2004; 75: 50-56
- Autoimmune phenomena in leprosy, particularly antinuclear antibodies and rheumatoid factor.J. Rheumatol. 1993; 20: 900-903
- Anti-cyclic citrullinated peptide antibodies and rheumatoid factor sera titers in leprosy patients from Mexico.Rheumatol. Int. 2012; 32: 3531-3536
- Anti-neutrophil cytoplasmic autoantibodies in leprosy.Br. J. Rheumatol. 1998; 37: 270-273
- Antiphospholipid antibodies in leprotic patients: a correlation with disease manifestations.Clin. Exp. Rheumatol. 2000; 18: 492-494
- High prevalence of antiphospholipid antibodies in leprosy: evaluation of antigen reactivity.Lupus. 2000; 9: 594-600
- Leprosy mimicking lupus erythematosus.Dermatol. Sin. 2014; 32: 47-50
- PCR-based techniques for leprosy diagnosis: from the laboratory to the clinic.PLoS Negl. Trop. Dis. 2014; 8: e2655
- Differentiation of patients with leprosy from non-infected individuals by the chemokine eotaxin/CCL11.Am.J.Trop. Med. Hyg. 2007; 77: 547-550
- Challenges in immunodiagnostic tests for leprosy.Expert Opin. Med. Diagn. 2013; 7: 265-274
Article info
Publication history
Published online: August 04, 2015
Accepted:
July 30,
2015
Received in revised form:
July 20,
2015
Received:
May 6,
2015
Identification
Copyright
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.