title: Isolated median neuropathy as the first symptom of leprosy.
abstract: BACKGROUND
  Focal peripheral neuropathy of the median nerve is mainly caused by a traumatic event or pressure, but it may also be produced by systemic illnesses. Among the latter, leprosy is a rare cause.
  
  
  METHODS
  Six cases of isolated median neuropathy as the first sign of leprosy were selected from patients with an exclusively neurological complaint as the initial symptom. The patients, evaluated at the National Leprosy Reference Center in Rio de Janeiro, Brazil, followed routine and specialized procedures.
  
  
  RESULTS
  Three of the patients had pure neural leprosy, and 3 had skin lesions. Clinical median nerve function impairment was confirmed by neurophysiological testing and histopathology. Both mononeuritis and mononeuritis multiplex were observed.
  
  
  CONCLUSIONS
  This case series demonstrates an additional form of presentation of leprosy, which, if not diagnosed and treated in time, may lead to permanent disability.
authors.affiliation: Leprosy Laboratory, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil. rt.vital@uol.com.br
authors.forename: Robson Teixeira
authors.initials: RT
authors.lastname: Vital
authors.forename: Ximena
authors.initials: X
authors.lastname: Illarramendi
authors.forename: Sérgio Luiz Gomes
authors.initials: SL
authors.lastname: Antunes
authors.forename: Márcio
authors.initials: M
authors.lastname: Nascimento
authors.forename: José Augusto
authors.initials: JA
authors.lastname: Da Costa Nery
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Nascimento
authors.forename: Euzenir Nunes
authors.initials: EN
authors.lastname: Sarno
authors.forename: Márcia Rodrigues
authors.initials: MR
authors.lastname: Jardim
mesh_terms: D000328:Adult; D004576:Electromyography; D019054:Evoked Potentials, Motor / Q000502:physiology; D005260:Female; D006801:Humans; D007918:Leprosy / Q000503:physiopathology*; D008297:Male; D020423:Median Neuropathy / Q000473:pathology* / Q000503:physiopathology*; D008875:Middle Aged; D010147:Pain Measurement; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology; D012867:Skin / Q000473:pathology; D014953:Wrist / Q000294:innervation; D055815:Young Adult
keywords: bone resorption; digital neuropathy; leprosy; median neuropathy, nerve biopsy; pure neural leprosy