Background: Carpal tunnel syndrome (CTS) has already been described as a possible form of neural leprosy presentation. However, the median nerve can be involved in this neuropathy in proximal segments and, sometimes, with an asymmetric impairment of the digital branches.
Objective: To detail the pattern of median nerve impairment through nerve conduction study (NCS) and ultrasound evaluation.
Methods: This cross-sectional study comprises 15 primary neural leprosy (PNL) patients and 14 patients with CTS who underwent peripheral nerve ultrasonography and NCS evaluation.
Results: From the total, 92.8% of patients with CTS and 80% with PNL had bilateral impairment of the median nerve, with 27 nerves in each group. Considering the cross-sectional area (CSA) of the tunnel (Mt) segment, 63% of the nerves in the CTS and 74.1% in the PNL groups were found to be thickened, with an average CSA of 13.4 ± 4.4 and 12.4 ± 4.6, respectively ( = 0.18). The CSA of the proximal tunnel (Mpt) segment showed thickening in only 3.7% in the CTS group and 96.3% in the PNL ( < 0.0001), with an average of 6.6 ± 1.3 and 17.0 ± 6.7, respectively ( < 0.001). Finally, 88.9% of the nerves in the PNL group and only 7.4% in the CSA ( < 0.0001) showed a reduction in conduction velocity in the distal forearm, with an average of 41.0 ± 6.3 and 53.2 ± 5.2, respectively ( < 0.0001).
Conclusion: The presence of neural thickening and demyelinating impairment in the segments proximal to the carpal tunnel favors the diagnosis of leprosy.
}, year = {2024}, journal = {Arquivos de neuro-psiquiatria}, volume = {82}, pages = {1-6}, month = {12/2024}, issn = {1678-4227}, url = {https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0044-1792092.pdf}, doi = {10.1055/s-0044-1792092}, language = {ENG}, }