02543nas a2200313   4500000000100000008004100001260001200042653001200054653002200066653002000088653002100108653002600129100001200155700001300167700001300180700001600193700001200209700001400221700001400235700001300249700001400262700001300276245010000289856008500389300000800474490000700482520172600489022001402215       2024                            d  c12/202410aleprosy10aPeripheral nerves10aUltrasonography10aElectromyography10a Mycobacterium leprae1 aAlves P1 aCirino F1 aGarcia L1 aFernandes J1 aLuppi A1 aAntunes D1 aPereira R1 aJunior W1 aGoulart I1 aSantos D00aMedian nerve impairment in leprosy: how does it differ from the classic carpal tunnel syndrome?  uhttps://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0044-1792092.pdf  a1-60 v823 a<p><strong>Background:&nbsp;</strong>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.</p>

<p><strong>Objective: </strong>To detail the pattern of median nerve impairment through nerve conduction study (NCS) and ultrasound evaluation.</p>

<p><strong>Methods: </strong>This cross-sectional study comprises 15 primary neural leprosy (PNL) patients and 14 patients with CTS who underwent peripheral nerve ultrasonography and NCS evaluation.</p>

<p><strong>Results: </strong>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 ( &lt; 0.0001), with an average of 6.6 ± 1.3 and 17.0 ± 6.7, respectively ( &lt; 0.001). Finally, 88.9% of the nerves in the PNL group and only 7.4% in the CSA ( &lt; 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 ( &lt; 0.0001).</p>

<p><strong>Conclusion: </strong>The presence of neural thickening and demyelinating impairment in the segments proximal to the carpal tunnel favors the diagnosis of leprosy.</p>
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