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From periphery to center, untold story of pure neuritic leprosy: an electrophysiological study

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Abstract

Background

Pure neuritic leprosy (PNL) is uncommon form of leprosy involving peripheral nerves. Some isolated case reports have shown imaging changes in the central nervous system (CNS) and also impairment in visual evoked potential (VEP), somatosensory evoked potential (SSEP) and brain stem auditory-evoked potentials (BAEPs) parameters in PNL, but there is lack of large study. This prospective observational study evaluates impairment in these central conduction studies among PNL patients.

Methods

We screened patients with leprosy presenting with features of neuropathy and/or thickened nerves. Patients with bacilli-positive nerve biopsies were included in the study and subjected to routine tests along with nerve conduction study (NCS), VEP, tibial SSEP and BAEPs. Parameters of these studies were analyzed based on data from previous studies.

Results

Of 76 patients screened for PNL 49 had positive findings in biopsy. Most of patients were male and mean age group was 46.35 ± 15.35 years. Mononeuritis multiplex was most common NCS pattern in 46.93% (23/49) patients. We found abnormal VEP in 13 out of 35 patients (37.14%). Similarly abnormal SSEP and BAEPs among 42.85% and 40% patients respectively.

Discussion

This study shows that in PNL significant number of patients have subclinical CNS involvement. Exact pathophysiology of CNS involvement is not known till now but study of VEP, SSEP and BAEPs parameter may help in early diagnosis of PNL.

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Data availability

Patient data is available with corresponding author and can be provided on request.

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Acknowledgements

We thank Mr Dibyendu Deewan and Mr Swadhin Nayak for Neurophysiology and secretarial help.

Funding

Financial grant: R&D Biotechnology project, Science and Technology Department, Govt of Odisha (ST-BT-MISC-0020–2018-4002/ST, Dated 12.9.2019).

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Authors and Affiliations

  1. Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India

    Sanjeev Kumar Bhoi, Yuvraj Lahre, Menka Jha, Priyanka Samal, Mukesh Kumar & Pritimayee Behera

  2. Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India

    Suprava Naik

  3. Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India

    Suvendu Purkait

  4. Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India

    Gautom Kumar Saharia

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  1. Sanjeev Kumar Bhoi
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  9. Pritimayee Behera
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Contributions

SKB: concept, design, literature search, data acquisition, data analysis, manuscript preparation. YL: data acquisition, data analysis, literature search, manuscript preparation. MJ: data analysis, manuscript editing and review. SP: pathologic evaluation, manuscript editing, manuscript review. SN: radiologic evaluation, manuscript editing, manuscript review. PS: manuscript editing, manuscript review. GKS: biochemical analysis, manuscript review MK: data acquisition, data analysis, literature search. PB: data collection, manuscript editing.

Corresponding author

Correspondence to Sanjeev Kumar Bhoi.

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All the authors declare that they have no conflict of interest.

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Ethical clearance has been obtained from Institute Ethics committee, AIIMS Bhubaneswar (Ref: T/EMF/Neuro/19/21).

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Written informed consent was obtained from all the participants of this study.

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Bhoi, S.K., Lahre, Y., Jha, M. et al. From periphery to center, untold story of pure neuritic leprosy: an electrophysiological study. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02503-2

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