RESUMO
Leprosy is a debilitating disease that usually involves the peripheral branches of the cranial nerves leading to anesthetic/hypoesthetic skin lesions and thickened peripheral nerves. However, the involvement of the central nervous system (CNS) is extremely rare. To the best of the author's knowledge, the involvement of the cranial nerve nuclei by leprosy has not been reported in the literature and the present case is the first report of involvement of the facial nerve nuclei by leprosy.
Assuntos
Doenças dos Nervos Cranianos/patologia , Nervo Facial/patologia , Hanseníase/patologia , Adulto , Humanos , MasculinoRESUMO
Involvement of cranial nerves is not uncommon in leprosy with trigeminal and facial nerves being commonly affected. Other cranial nerves can also be involved especially in longstanding cases of leprosy towards the lepromatous pole. Herein, we report a case of leprosy with multiple cranial neuropathy mimicking Melkerson Rosenthal syndrome.
Assuntos
Doenças dos Nervos Cranianos/etiologia , Doenças dos Nervos Cranianos/fisiopatologia , Hanseníase/complicações , Hanseníase/diagnóstico , Síndrome de Melkersson-Rosenthal/diagnóstico , Adulto , Idoso , Antituberculosos/uso terapêutico , Doenças dos Nervos Cranianos/tratamento farmacológico , Doenças dos Nervos Cranianos/patologia , Diagnóstico Diferencial , Nervo Facial/fisiopatologia , Nervo Glossofaríngeo/fisiopatologia , Humanos , Hanseníase/classificação , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Nervo Trigêmeo/fisiopatologiaRESUMO
BACKGROUND: Leprosy is one of the most common causes of peripheral neuropathy, perhaps closely matched by diabetic neuropathy. Patterns of peripheral neuropathy in leprosy can be varied, which may include mononeuropathy, mononeuritis multiplex and symmetric polyneuropathy. Cranial nerves, especially facial and trigeminal nerves, are also commonly involved in leprosy. AIMS: To find out the pattern and spectrum of cranial nerve involvement in a consecutive series of patients with leprous neuropathy. SETTINGS AND DESIGN: A retrospective review of patients admitted with leprosy to the Neurology Department of a tertiary care center. MATERIALS AND METHODS: All consecutive patients admitted during an 8-year period (1995-2003) and diagnosed to have leprosy were included. They were clinically evaluated to determine the frequency and pattern of cranial nerve involvement. RESULTS: About 18% (9/51) of the leprosy patients seen during that period had clinical evidence of cranial nerve involvement. Facial and trigeminal nerves were the most commonly affected (five and four patients respectively). CONCLUSIONS: Cranial nerve involvement is common in leprosy, which emphasizes the need to carefully examine them. Also, one should exclude leprosy in patients presenting with isolated cranial neuropathies.
Assuntos
Doenças dos Nervos Cranianos/etiologia , Doenças dos Nervos Cranianos/patologia , Nervo Facial/patologia , Hanseníase/complicações , Hanseníase/patologia , Nervo Trigêmeo/patologia , Adulto , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Pele/patologiaAssuntos
Doenças dos Nervos Cranianos/diagnóstico , Hanseníase Tuberculoide/diagnóstico , Polineuropatias/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Biópsia , Doenças dos Nervos Cranianos/patologia , Nervos Cranianos/patologia , Humanos , Hanseníase Tuberculoide/patologia , Masculino , Mononeuropatias/diagnóstico , Mononeuropatias/patologia , Polineuropatias/patologiaRESUMO
Facial and trigeminal nerve involvement was studied in 43 leprosy patients, 5.7% of the 750 Thai national in-patients of a leprosy rehabilitation centre. Involvement of the facial nerve occurred late in the disease and had an average duration of 12.1 years. The zygomatic branches of this nerve were the most frequently affected. Hypaesthesia and anaesthesia were most often observed in the maxillary divisions. Periorbital surgical procedures to prevent severe ocular complications are evaluated and discussed.