Neuropathy of leprosy: the characteristics of cases seen between 1962 and 1995
Introduction. Neuropathy due to leprosy is the most frequent cause of peripheral nervous system disorders due to an infective agent, one of the commonest aetiologies of peripheral neuropathy, and also one of the few peripheral neuropathies which is curable. Hansen’s disease, initially and predominantly involves the skin, so it is not usually seen by a neurologist; a neurologist sees cases which are difficult to diagnose and often after the condition has been ruled out by other doctors from other medical specialities. Patients and methods. In the National Institute of Neurology and Neurosurgery of La Habana, Cuba, 18 nerve biopsies were studied (during its history), that had been diagnosed as leprous neuropathy. We reviewed the clinical histories of all the patients admitted to this centre. The sample was characterized by: age, sex, neuro[1]logical clinical picture, nerves most affected, skin lesions, electrophysiological studies and a description of the anatomo[1]pathological findings. Results and discussion. Most patients were male and all (100%) were adults of ‘working age’ (19-65 years). The most frequent neuropathic pattern was multiple mono-neuropathy (78%) and the quality, purely sensitive or mixed was predominantly sensitive (100%). The nerves most affected were the ulnar (10 patients) and median (6 patients). The most frequent skin lesions were anesthetic maculae. Anatomo-pathological study showed inflammatory infiltration in all patients and the bacillus was absent in only one case
Pacientes y métodos Se evaluaron 18 biopsias de nervio diagnosticadas como neuropatía por lepra y realizadas en el Instituto Nacional de Neurología y Neurocirugía de La Habana, Cuba, en el transcurso de toda su historia, y revisamos las historias clínicas de todos los pacientes ingresados en el centro. La muestra se caracteriza por: edad, sexo, cuadro clínico neurológico, nervios más comprometidos, lesiones de piel, estudios electrofisiológicos y descripción del estudio anatomopatológico. Resultados y discusión. La mayoría de los pacientes eran del sexo masculino y sus edades en el 100% eran las reconocidas como laboralmente activas (19-65 años). El patrón neuropático más frecuente fue el mononeuropático múltiple (78%) y la calidad, sensitiva pura o mixta, fue predominantemente sensitiva (100%). Los nervios más afectados fueron el cubital (10 pacientes) y el mediano (6 pacientes). Las lesiones de piel más frecuentes fueron las máculas anestésicas. La anatomía patológica mostró infiltrado inflamatorio en todos los pacientes y el bacilo estuvo ausente sólo en uno
