Description of electroneuromiographic and laboratorial findings in leprosy neuropathy, according to its clinical forms: the confirmation of a spectral disease.
Level 4 - case-series / case-control
Retrospective case series of patients at a single reference center
PubMed 38259847 · doi:10.3389/fmed.2023.1304131
What was done
Retrospective observational study of medical records from 513 patients with leprosy evaluated at a National Reference Center of Sanitary Dermatology and Leprosy in Brazil between 2014 and 2022. Patients underwent electroneuromyography (ENMG) at the time of diagnosis along with clinical, serological, and molecular evaluations to characterize peripheral nerve involvement across clinical forms.
What was found
Across the cohort, 126 patients had normal ENMG findings and 387 (75.4%) had abnormalities, totaling 2,671 altered nerves (mean 6.9 ± 5.1 per patient). Among patients with abnormal ENMG, 86.8% (336/387) had multiple mononeuropathy and 13.2% (51/387) had mononeuropathy. The most affected sensory nerves were the superficial peroneal (25.0%; 413/1649), sural (15.1%; 397/2627), and ulnar (13.8%; 363/2627), averaging 4.3 ± 3.2 affected sensory nerves per patient. The most affected motor nerves were the ulnar (33.1%; 338/1022) and common peroneal (12.1%; 319/2627), averaging 2.6 ± 2.5 affected motor nerves per patient. Axonal damage was more common in primary neural, borderline-tuberculoid, borderline-lepromatous, and lepromatous forms.
Why it matters
This study provides large-scale electrophysiological mapping of leprosy neuropathy, confirming that multiple mononeuropathy with prominent axonal involvement across specific sensory and motor distributions is the predominant neurophysiological presentation.
Limits
Single-center retrospective design subject to referral and documentation bias. There was no control group, and the abstract mentions serological and molecular testing but provides no quantitative results for those laboratory measures.
Cited by
- supports Leprosy remains a leading cause of peripheral neuropathy worldwide.