ELECTROPHYSIOLOGICAL EVALUATION OF NERVES DURING REACTIONS IN LEPROSY

Forty-two patients with leprosy (7 with tuberculoid type, 30 borderlin e, 5 lepromatous) were studied electrophysiologically during reactions . Thirty-three had type I reactions while 9 had type II reactions. Eac h patient received 60 mg/day prednisolone tapered over a 6-week period . Motor conduction studies were performed on one clinically affected a nd one unaffected nerve and were repeated 12 weeks after the beginning of steroid therapy. Significant motor conduction abnormalities were o bserved in 14 affected (33.3%) and 8 unaffected nerves (19.1%). The ma jority of these nerves were in patients with borderline leprosy having type I reactions. Following steroid therapy, nerve function improved in 14 affected (33.3%) and 20 unaffected nerves (47.66%). However, 5 a ffected (10.2%) and 12 unaffected nerves (28.5%) showed a worsening of nerve function following steroid therapy. The majority of the nerves that showed improvement with steroid therapy had type I reactions, whi le those that showed deterioration had type II reactions. Steroids imp roved nerve function mainly in patients with type I reactions. Their r ole in patients with type II reactions remains debatable.