Study of elcetrophysiological changes in clinically uninvolved nerves in Leprosy

Abstract

Introduction: The present day classification of leprosy depends on the number of nerves affected [WHO]. Detection of changes in clinically uninvolved nerves can have a major impact on diagnosis, classification and treatment of leprosy patients. Aim: Study of nerve conduction parameters in a segmental manner in commonly involved peripheral nerves and detection of electrophysiological changes in clincally uninvolved nerves. Method: Leprosy was clinically diagnosed on the basis of criteria put forward by WHO. Segmental electrophysiological studies were done in 30 cases and 30 controls after obtaining informed consent. Both ulnar nerves, common peroneal nerves and posterior tibial nerves were studied. Sensory and motor parameters were studied. Observation: Thirty patients and controls were studied. 60 nerves were clinically involved. 180 clinically uninvolved nerves were also studied. Clinically uninvolved nerves were compared with the same nerves in normal persons having no peripheral neuropathy. Results: Segmental demyelination and axonal degeneration were observed in clinically uninvolved nerves. Conclusion: Clinically uninvolved nerves showed changes in electrophysiological studies. Detection of involvement of clinically uninvolved nerves can modify diagnosis, classification and treatment of leprosy.