Leprosy impacts brain, spinal cord: KGMU study

Lucknow: A systematic review and meta-analyses of published cases done by department of neurology at the King George’s Medical University (KGMU) has concluded that leprosy can affect brain and spinal cord too.

Prof. R K Garg, HoD neurology at the KGMU, said: “It was earlier believed the mycobacterium leprae, the bacteria that causes leprosy, primarily troubles the peripheral nerves and does not affect brain and spinal cord. Our study has found it can affect the brain and spinal cord too.”

This systematic review aimed to investigate central nervous system (CNS) involvement in leprosy by analysing multiple cohort studies, individual cases and case series.

A total of 34 records were identified, including 18 cohort studies and 16 reports describing 27 isolated cases.

“Bacteria enters in a human body through respiratory passage via airborne route, causing leprosy in a normal person,” said Garg.

The research paper ‘the spectrum of central nervous system manifestations in leprosy: A systematic review of published case reports and case series, was published in the journal The Royal Society of Tropical Medicine and Hygiene in September .

“Autopsies revealed macroscopic changes in the spinal cord. Mycobacterium leprae was detected in neurons of the medulla oblongata, the connection between the brainstem and the spinal cord. In 21 patients (78 per cent) spinal cord/brachial plexus abnormities were detected,” he said.

“For our conclusion, we evaluated studies describing autopsy/biopsy findings, cerebrospinal fluid (CSF) changes, EEG evoked potentials and neuroimaging,” he added.

The current treatment for leprosy is multidrug therapy (MDT).

Asked if his finding calls for change in treatment, Garg said, currently there will not be any change in the treatment, but doctors need to have caution that brain and spinal cord may be affected that is now amply proven.

Leprosy is an ancient disease that has been documented in the literature of ancient civilisations. It is a chronic infectious disease caused by a specific type of bacteria known as Mycobacterium leprae. The condition primarily affects the skin, peripheral nerves, mucosa of the upper respiratory tract and eyes.