02998nas a2200349   4500000000100000008004100001260004400042653002400086653001000110653001000120653001800130653001200148653002500160653001700185653001100202653002500213100001600238700001200254700001200266700001400278700001500292700001200307700001200319700001200331700001300343700001400356245008600370856012800456300000700584520204300591022001402634       2025                            d  bSpringer Science and Business Media LLC10aBrachial plexopathy10aBrain10aCemri10aCervical cord10aLeprosy10aLeprous ganglionitis10aNeuroimaging10aSignal10aIntensity alteration1 aElangovan K1 aKumar S1 aGarg RK1 aParihar A1 aMalhotra K1 aVerma P1 aRawat D1 aKumar N1 aReddy HD1 aSuvirya S00aNeuroimaging in Leprosy: A Case Series Exploring Domains Beyond Peripheral Nerves  uhttps://www.cureus.com/articles/350959-neuroimaging-in-leprosy-a-case-series-exploring-domains-beyond-peripheral-nerves.pdf  a253 a<p><strong>Background and objective:&nbsp;</strong>Leprosy, an infectious disease caused by Mycobacterium leprae, induces irreversible damage, necessitating early detection. The disease's neurotropism, which extends to the peripheral nerves, is well recognized. In recent years, there has been an acknowledgment of its expanding horizon beyond this traditional boundary. This study aims to explore the involvement of atypical sites such as the central nervous system, brachial plexus, and spinal nerve root ganglion through dedicated neuroimaging via magnetic resonance imaging (MRI) across diverse spectra of leprosy.</p>

<p><strong>Methods:&nbsp;</strong>In a retrospective case series conducted from July 2020 to July 2022 at a tertiary care hospital, leprosy patients with specific neurological signs were analyzed. Neurologists had recommended MRI for suspected central nervous system (CNS)/proximal nerve root involvement in these patients. Two expert radiologists assessed the MRI imaging results.</p>

<p><strong>Results:&nbsp;</strong>Eleven such patients were identified, of which six with positive MRI findings were scrutinized. Six multidrug therapy (MDT) naive male leprosy patients in the age range of 24-44 years were analyzed. MRI revealed signal intensity alterations (SIA) in the brain, cervical cord, and bilateral/unilateral brachial plexus/ganglion. After a year of MDT, follow-up imaging revealed diverse responses: complete resolution of brain SIA (n=1), persistent declining hyperintensity in the cervical cord with declining (n=1), unchanged ganglionitis/plexitis (n=2), and no observable changes in cord and brachial plexus SIA (n=1).</p>

<p><strong>Conclusion:&nbsp;</strong>This study reveals diverse neuroimaging patterns in leprosy patients. Neuroimaging may reveal abnormalities, particularly in patients with leprosy presenting with lower motor neuron-type facial palsy. A deeper understanding of these radiological findings could offer valuable insights into the pathophysiology of leprosy.</p>
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