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 CASE REPORT
Year : 2020  |  Volume : 68  |  Issue : 4  |  Page : 922--926

Mononeuritis Multiplex as Initial Manifestation of Pure Neuritic Leprosy—A Forgotten Cause: Clinical, Electrodiagnostic and Pathologic Correlations


1 Department of Neurology, Yenepoya Medical College, Yenepoya (deemed to be) University, Mangalore, Karnataka, India
2 Department of Pathology, Kasturba Medical College, Mangalore, (Manipal University), Karnataka, India
3 Department of Dermatology, Yenepoya Medical College, Yenepoya (deemed to be) University, Mangalore, Karnataka, India

Correspondence Address:
Dr. Bhaskara P Shelley
Professor and Head, Department of Neurology, Fellowship in Behavioural Neurology (UK) & Fellowship in Cognitive Neurology (UK), Yenepoya Medical College, Yenepoya (deemed to be) University, Mangalore - 575 022, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.293485

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Despite being common, polyneuropathy remains a diagnostic challenge for most clinicians. Mononeuritis multiplex (MM) refers to involvement of several or many peripheral nerves at the same or different points in time by a disease process. This report describes a case of an atypical presentation of Hansen's disease (HD) as mononeuritis multiplex in the left lower limb with corresponding radiographic, electrodiagnostic, and histopathological data that confirmed pure neuritic leprosy (PNL). We reiterate that although the incidence of PNL is exceedingly low characterized by nerve involvement without the characteristic cutaneous stigmata, leprosy is still the commonest cause of MM in the Indian sub-continent.This report underscores the crucial need for a heightened multi-disciplinary awareness of this “forgotten and uncommon” presentation of PNL. It is imperative that the treating physician should also understand the various neurological presentations, both mimics and chameleons, of this treatable disease to prevent permanent neuropathic injury and disability.






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