NEUROLOGIC CHANGES IN VISCERAL LEISHMANIASIS

Neurologic changes in visceral leishmaniasis (VL) are rarely reported. From January 1992 to April 1993, 111 patients with VL were seen at So ba University Hospital in Khartoum, Sudan. Fifty-two (46%) patients ha d neurologic symptoms or signs; the most common symptom was a sensatio n of burning feet. Four patients had foot drop. Five patients had deaf ness and one patient had multiple cranial nerves palsies. None of our patients had vitamin deficiency or any of the other known causes of ne uropathy. Nerve conduction studies in 15 patients showed evidence of a xonal degeneration and demyelination, which were confirmed by histopat hology and electron microscopy of nerve biopsies. There was no direct parasitic infection of the nerve and there was no neuritis. In most pa tients, the sensory symptoms disappeared within two weeks in most of o ur patients after specific anti-leishmanial treatment. Motor recovery was much slower. Audiographic studies in five patients with deafness s howed it to be sensory-neural. Hearing returned to normal after treatm ent with sodium stibogluconate. Further studies are needed to define t he etiology of the nerve pathology in patients with VL.