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September 1968

Mononeuritis Multiplex in Lepromatous Leprosy

Author Affiliations

New York
From the Neurological Clinical Research Center, Department of Neurology, College of Physicians and Surgeons, and the Neurological Institute, Columbia-Presbyterian Medical Center, New York.

Arch Neurol. 1968;19(3):310-314. doi:10.1001/archneur.1968.00480030088009

MONONEURITIS multiplex refers to involvement of several or many peripheral nerves at the same or different points in time by a disease process. It is usually asymmetric, particularly in early stages, and has been reported to occur in periarteritis nodosa,1 diabetes mellitus,2 and leprosy.3-7

Two main types of leprosy, lepromatous and tuberculoid, have been described.3,4 Low resistance in lepromatous leprosy is evidenced by a negative lepromin skin test and positive skin scrapings for acid-fast bacilli. Patients present with papular or nodular pigmented skin lesions together with slowly progressive symmetrical sensory polyneuropathy. Considerable resistance occurs in tuberculoid leprosy as indicated by a strongly positive lepromin skin test and negative skin scrapings for acid-fast bacilli. It begins with depigmented slightly erythematous skin lesions and a sudden severe asymmetric neuritis (mononeuritis multiplex). Borderline and indeterminate groups of leprosy have also been described.

Electromyographic (EMG)5-7 and time-intensity curve studies

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