Neuroimaging in leprosy: the nerves and beyond

Objective

To elucidate the spectrum of findings on neuroimaging in leprosy with special reference to magnetic resonance imaging (MRI).

Methods

We retrospectively reviewed the neuroimaging findings on MRI in thirty-two patients with leprosy where dedicated plexus, brain and spine imaging had been performed.

Results

Twenty-two patients had positive findings on imaging. Six patients showed involvement of the peripheral nerves as thickening and formation of micro or macroabscesses. The brachial plexus showed thickening and hyperintensity in ten patients, with associated involvement of the lumbosacral plexus in one patient. Four patients showed spinal cord involvement as discrete T2 hyperintense lesions with postcontrast enhancement. Intracranial lesions involving the nucleus ambiguus and facial colliculus were seen in two patients.

Conclusion

Neuroimaging in Hansen's disease has brought several new findings to the fore front. Besides peripheral nerves, involvement of the centrally located plexuses, spinal cord and brain has also been seen which thus expands the imaging spectrum of the disease.