Abstract

Background-Leprosy, also known as Hansen's disease (HD), is long term infection caused by the bacilli Mycobacterium leprae and Mycobacterium lepromatosis. Infections are without symptoms and typically remain this way from 5 to as long as 20 years. Symptoms that develop include granulomas of the nerves, respiratory tract, skin, and eyes. This may result in a lack of ability to feel pain and thus loss of parts of extremities due to repeated injuries or infection due to unnoticed wounds. [4] Weakness and poor eyesight may also be present.The peripheral nerve injury has been associated with physical disability and is considered to be the most serious complication of leprosy. The diagnostic tests including nerve conduction velocity testing and ultrasound of ulnar nerve may reveal the defect in the nerve before the disease become clinically more apparent.

Results-50 patients of leprosy were assessed for disability degree, including 46% female and 54% males (table 1). The mean age of the patients was 38.8 years with median age of 38 years. Majority of the patients has low education; 38% had between 0-4 years education, 32% had education between 5-9 years and 30% above ≥9 years (table 1). 74% of the patients had more than two nerves involved. According to the operational classification, there was a Prevalence of Paucibacillary disability 10.88% (table 2).  In most of the cases 82% had no leprosy reaction. The most frequent clinical forms were boderline tuber culoid (46%) and indeterminate (14%) and borderline number (14%). Regarding the degree of disability 78% had leprosy grade 0, 18% had grade 1 and 4% had grade 2.

Conclusion-The study showed that number of affected nerves, leprosy reaction, operational classification and clinical presentation were the main factors associated with the development of physical disabilities. Sonography and electrophysiology were complementary for identifying ulnar nerve neuropathy in patients with leprosy, with clinical symptoms as the reference standard. This reinforces the role of sonography in the investigation of leprosy ulnar neuropathy.

Sural nerve biopsy in experienced hands is safe and that it has revealed pathological changes of significance in this group of patients.

Keywords - Hansens Disease,Central India.