Study of patients presenting with symptoms of peripheral neuropathy and thickened greater auricular nerve.
OBJECTIVE
To analyze symptoms and make a clinical diagnosis of leprosy in patients presenting with symptoms of peripheral neuropathy and found to have thickened greater auricular nerve.


METHODS
Cross-sectional study.


METHODS
Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu. Patients attending the medical out-patient department of this hospital were taken in the study.


METHODS
40 patients presenting with symptoms of peripheral neuropathy and are found to have thickened greater auricular nerve were included.


RESULTS
Thickened greater auricular nerve and sensory symptoms showed male predominance (97.5%). Mean age of involvement was 28.65 years. The symptom most frequently complained of was chest pain (75%), followed by pins and needle sensation 67.5%, burning of the upper extremities, nape of the neck and chest 57.5%, palpitation 45%, disturbed sleep mostly said to be due to burning 35%, sweating 20%, dizziness 17.5%, shortness of breath 7.5%, and numbness of the limbs in 2.5%. None of the patients had somatic neuropathy. Autonomic neuropathy was present in 42.5 %.


CONCLUSIONS
1. In endemic areas patients with thickened peripheral nerve and sensory symptoms should be diagnosed clinically as primary neuritic leprosy. 2. In absence of objective loss of somatic sensation autonomic neuropathy may be the only early indicator of neuritis. 3. Close follow up of these patients is necessary.
Neopane
A
A
Department of Medicine, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal. neopane@vsnl.com
Upadhyaya
B
B
Dungana
S
S
Karki
D B
DB
D000293:Adolescent; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D002637:Chest Pain / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015441:Leprosy, Tuberculoid / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000503:physiopathology