Clinical and electrophysiological evaluation of nerve function impairment following cessation of multidrug therapy in leprosy

Seventeen multibacillary (MB) and 15 paucibacillary (PB) cases of leprosy w ho had had regular and adequate multidrug therapy (MDT) were examined clini cally and electrophysiologically at periodic intervals for 1 year following cessation of MDT. All the major nerves were assessed for nerve function im pairment (NFI). Overall, two MB (13.3%) and three PB (20%) cases showed sig ns of deterioration clinically and/or electrophysiologically. The nerve con duction (NC) follow-up studies revealed no significant improvement in the s ensory conduction in both the MB and PB groups of nerves, whilst motor cond uction showed a significant improvement at the first 6-monthly follow-up am ong the MB group of nerves. At the study onset, sensory impairment (MB = 62 %, PB = 25%) predominated over motor in terms of both severity and frequenc y. The lower extremity was more frequently and severely affected than the u pper in both groups of patients. As an individual test, NC measurement prov ed to be more sensitive in detecting NFI, but the combination of physical p alpatation for nerve thickening and graded nylon test (GNT) was closely com parable to measurement of nerve conduction.