Nota Clínica

Pure neural leprosy. Diagnostic aspects of a clinical case

J.M. Pardal-Fernández, S. Ezsol-Lendvai, M. Rodríguez-Vázquez, J.L. Agudo-Mena, B. Godes-Medrano [REV NEUROL 2016;63:257-261] PMID: 27600740 DOI: https://doi.org/10.33588/rn.6306.2016110

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Volumen 63 | Number 06 | Nº of views of the article 10.062 | Nº of PDF downloads 299 | Article publication date 16/09/2016

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ABSTRACT

INTRODUCTION Leprosy is an infectious disease caused by the bacteria Mycobacterium leprae. It is particularly prone to affect the skin and the nerve trunks and, in fact, both are compromised in most infected patients. It is transmitted by exposure to those with the disease and sometimes by reactivation. One uncommon possibility is pure neural leprosy, which is characterised by neuropathy, but without skin lesions. We report the case of a patient with pure neural leprosy and review the diagnostic aspects.

CASE REPORT A 40-year-old male, an immigrant who was diagnosed and treated for leprosy 20 earlier. The patient visited due to painful paraesthesias and dysesthesias in the hands and legs without the presence of any skin lesions. Acute multiple mononeuritis with mainly ulnar involvement was observed. The disease, typified as paucibacillary/tuberculoid, was treated and in a few weeks there was a clear improvement.

CONCLUSIONS In this case of pure neural leprosy due to reactivation, early diagnosis allowed timely treatment to be established. Evaluation of neuropathy together with clinical, electrophysiological and ultrasound criteria is recommended. By so doing, a high degree of sensitivity is achieved as well as allowing early diagnosis and treatment, and therefore a better functional recovery. KeywordsElectrodiagnosis Leprosy Multiple mononeuritis Neurophysiology Pure neural leprosy Ulnar neuropathy Ultrasonography Ultrasound imaging CategoriesNervios periféricos, unión neuromuscular y músculo Neurofisiología Técnicas exploratorias

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Nota Clínica

Pure neural leprosy. Diagnostic aspects of a clinical case