Korean J Clin Neurophysiol.  2013 Jun;15(1):19-23. 10.14253/kjcn.2013.15.1.19.

Leprous Neuropathy Associated with Predominant Proprioceptive Sensory Loss

• Yoon TK
• Jo HY
• Yuk JW
• Shin JH
• Kim DS

• KMID: 2225196
• DOI: http://doi.org/10.14253/kjcn.2013.15.1.19

Abstract

Some patients with leprosy may present with atypical features, such as isolated peripheral neuropathy without skin lesions, or marked proprioceptive dysfunction. We report a 56-year-old female who presented with predominant proprioceptive loss without skin lesion, but was finally confirmed as leprous neuropathy by sural nerve biopsy. It is postulated that large myelinated fibers were affected by chronic immunological reactions triggered by inactive bacterial particles, producing a peripheral neuropathy presenting as predominant proprioceptive sensory loss without typical skin lesions.

Keyword

Leprosy; Proprioception; Peripheral neuropathy

MeSH Terms

Biopsy
Female
Humans
Leprosy
Myelin Sheath
Organic Chemicals
Peripheral Nervous System Diseases
Proprioception
Skin
Sural Nerve
Organic Chemicals

Figure

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  Figure 1. Sural nerve biopsy findings of the patient. (A) Almost complete loss of myelinated nerve fibers was observed with thickening and hypertrophy of epineurial sheath (H&E stain ×100). (B) On longitudinal sections, perivascular inflammatory infiltrates were prominent (Modified Gomori-trichrome stain ×100). (C) A non-caseating granuloma with giant cells are seen (H&E stain ×400). (D) On Fite stain, no acid-fast bacilli were observed (Fite stain, ×100). The black bars represent 100 μm.

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