A Sensory Nerve Conduction Study of Sural Nerve Among Leprosy Patients

Leprosy neuropathy is characterized by initial involvement of the small nerve fibers, later followed by involvement of the large fibers, when routine nerve conduction studies become abnormal. Sural nerve is main sensory supplying of the foot. Mostly, ulcer occurs in foots due to neuropathy of lower limb which is most early & neglected complication of lower Limb among leprosy Patients. Early assessment of Sural nerve is more important in leprosy. The results of Nerve Conduction Studies are closely parallel to the structural abnormality of Nerve. Aim:-To assess the sensory nerve conduction study parameters of the Sural nerve in cases of clinically manifest leprosy with or without nerve damage. Method: To increase the diagnostic yield, we applied the Antidromic SNCS near nerve technique to the Sural nerve of 42 leprosy patients. Result: Sural Nerve was not detected by NCS in 11(26.19%) Leprosy patient out of 42. This may be due to conduction block. Mean Latency of Bilateral Sural nerve was prolonged and SNCv was reduced. That represented demyelinating type of Neuropathy of Sural Nerve. Conclusion: Demyelinating neuropathy of Sural Nerve is more common than Axonal Neuropathy in Leprosy cases. Total nerve conduction block might be developed in early stage. Axonal Neuropathy may develop with or without conduction block. To better understand the neurophysiology and physiology of leprosy and to increase the accuracy and precocity of the diagnosis, it will be necessary to investigate patients in the very early stages of the disease and to correlate these findings with the corresponding nerve pathology