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Year : 2021  |  Volume : 69  |  Issue : 5  |  Page : 1349--1353

Pure Neuritic Leprosy with Bilateral Foot Drop and Central Nervous Involvement: A Clinical, Electrophysiological, and MR Correlation

Sanjeev K Bhoi1, Suprava Naik2, Suvendu Purkait3 
1 Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
2 Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
3 Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

Correspondence Address:
Sanjeev K Bhoi
Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha - 751 019
India

Background: Central nervous system (CNS) involvement in leprosy is sparsely documented. Neurophysiological tests and magnetic resonance imaging (MRI) helps in demonstrating CNS involvement in the patient of pure neuritic leprosy. Objectives: To demonstrate CNS involvement in pure neuritic leprosy. Methods: Detailed clinical presentation and skin lesions were evaluated. Sural nerve biopsy, MRI diffusion tensor imaging of spinal cord and optic nerve were performed. Visual evoked potential and tibial somatosensory evoked potential were done. Their clinical, electrophysiological, and MRI were done at follow-up visits. Results: We report three patients of pure neuritic leprosy with bilateral foot drop as the initial presentation. MRI T2W sequence of cervico dorsal cord showed dorsal column hyperintensity in two patients. Diffusion-weighted MR revealed decrease fractional anisotropy and an increase in the apparent diffusion coefficient. Similar findings were also noted in the optic nerves. The patients were managed with multidrug therapy multibacillary regimen and steroid in tapering dose. At follow-up, they showed clinical improvement in vision and power of ankle dorsiflexor. Conclusions: Patients of pure neuritic leprosy may manifest with bilateral foot drop with the involvement of posterior column and cranial nerves.


How to cite this article:
Bhoi SK, Naik S, Purkait S. Pure Neuritic Leprosy with Bilateral Foot Drop and Central Nervous Involvement: A Clinical, Electrophysiological, and MR Correlation.Neurol India 2021;69:1349-1353


How to cite this URL:
Bhoi SK, Naik S, Purkait S. Pure Neuritic Leprosy with Bilateral Foot Drop and Central Nervous Involvement: A Clinical, Electrophysiological, and MR Correlation. Neurol India [serial online] 2021 [cited 2022 Jan 17 ];69:1349-1353
Available from: https://www.neurologyindia.com/article.asp?issn=0028-3886;year=2021;volume=69;issue=5;spage=1349;epage=1353;aulast=Bhoi;type=0