A Cross-sectional Study on the Electrophysiological Profile of Leprosy Patients in a Tertiary Care Institute in Chhattisgarh, India

Abstract

Introduction: Leprosy is a bacterial infection caused by Mycobacterium leprae. It mainly infects skin, mucosa and nerves. Neural involvement is primarily due to the selective affinity of Schwann cells for lepra bacilli. Nerve involvement leads to Nerve Function Impairment (NFI) which presents as sensory and/or motor deficit, cutaneous nerve thickness or painful neuritis eventually lead to deformity and disability. NFI can be accessed by Nerve Conduction Study (NCS). Early diagnosis and treatment plays important role in the prevention of permanent nerve damage due to leprosy. Aim: To study the electrophysiological profile of Pure Neuritic Leprosy (PNL), Tuberculoid Hansen’s Disease (TTHD) and Borderline Tuberculoid Hansen’s Disease (BTHD). Materials and Methods: A cross-sectional study was conducted on 63 newly diagnosed patients in dermatology Out Patient Department (OPD) in Late Shri Lakhiram Agrawal Memorial Medical College, Raigarh, Chhattisgarh, India, from June 2020 to May 2021. The NCS was conducted after obtaining approval from the Institutional Ethical Committee. The bilateral ulnar nerve, median nerve, common peroneal nerve, posterior tibial nerve and sural nerve were assessed by NCS for each patient. Data was collected and analysed by unpaired student's t-test using Statistical Package for the Social Sciences (SPSS) software version 21.0. Results: Total 378 nerves were examined for nerve thickness. Total 106 nerves were found to be thickened. The most common neuropathy found was of demyelinating sensory and sensorimotor type seen in 21 (33.33%) patients. A total of 12 (19.05%) patients had both axonal and demyelinating neuropathy (mix neuropathy). Only 5 (7.94%) patients had pure axonal neuropathy of sensorimotor or sensory nerves. Conclusion: Most common neuropathy found was demyelinating sensory and sensorimotor neuropathy. The ulnar nerve was found to be the most common nerve involved in leprosy.

Keywords

• axonal neuropathy
• demyelinating neuropathy
• hansen disease
• nerve conduction study
• nerve function impairment