British Leprosy Relief Association
aDepartment of Clinical Neurosciences, Nerve-Muscle Unit, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne
bDepartment of Clinical Pathology, University Hospitals of Geneva (HUG), Geneva, Switzerland
Correspondence to: Pinelopi Tsouni, Department of Clinical Neurosciences, Nerve-Muscle Unit, CHUV, Rue du Bugnon 46, 1011 Lausanne, Switzerland (Tel: +41 21 314 12 91; Fax: +41 21 314 12 56; e-mail: firstname.lastname@example.org)
Patient consent: Oral and written informed consent was obtained from the two patients for publication of this paper and any accompanying images.
We describe two cases of sensory mononeuritis that presented with similar past medical histories, and clinical and electrophysiological features. The two patients were females who had resided in areas endemic for leprosy (Brazil). Both developed a progressive, purely sensory, painful mononeuritis distally in the lower limbs with sensory nerve potentials asymmetrically reduced in amplitude. The sural nerve biopsy performed in Patient 1 showed granulomatous inflammation of the epineurial tissue, consistent with paucibacillary pure neural leprosy (PNL) while in Patient 2 there were signs of vascular inflammation consistent with non-systemic vasculitic neuropathy (NSVN). Patients 1 and 2 both improved following targeted treatment with rifampicin and dapsone vs. rituximab, respectively.
sensory painful mononeuritispure neural leprosyvasculitic neuropathynerve biopsy