Syringomyelia diagnosed with leprosy: A case report

Abstract

Leprosy has high incidence in tropical and subtropical countries. We document a case of 26-year-old female with an 18-month history of insidious onset progressive weakness and wasting of small muscles of both hands with decreased sensation distal to elbows and trophic changes without thickened nerves. The patient was on anti-leprosy treatment for the past 1 year with no response to treatment. Examination revealed diminished reflexes in the upper limbs and preserved reflexes in the lower limbs. Skin biopsy was normal. Magnetic resonance imaging of the spine was suggestive of Arnold–Chiari malformation type I with large cervico-dorsal syrinx which was ultimately treated by the surgical management. We suggest that all cases of leprosy should include syringomyelia as a differential diagnosis so that unnecessary prolonged exposure to anti-leprosy drugs with potential side effects can be prevented.

Keywords

• arnold-chiari malformation type i
• leprosy
• syringomyelia