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      Re: leprosy

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Posted by CCF NEURO MD on May 14, 1997 at 17:55:31:

In Reply to: leprosy posted by Dax on May 11, 1997 at 14:57:15:

: I have been researching the topic of leprosy for an OAC
  course but have had trouble finding the exact cause of
  its disfuguring traits.  Aside from the fact its caused
  by Mycobacterium leprae which effects the axons I have no
  information in how it damages the nerves.  Could
  someone email me as to how it causes this paralysis? Is
  it the result of inflamation only?
Here is some information from medhelps library.

At the end I will answer your question on how leprosy affects the nerves.

Leprosy (Hansen's disease)

What is leprosy?

Leprosy is a chronic bacterial disease of the skin, nerves in the hands
and feet and, in some cases, the lining of the nose. Leprosy is a rare
disease in the United States.

Who gets leprosy?

Anyone can get leprosy, but children seem to be more susceptible than adults.

How is leprosy spread?

It is not clear how the leprosy germ is spread, but household and prolonged
close contact is important. The germs probably enter the body through the
nose and possibly through broken skin. The germs get in the air through nassal
discharge of untreated lepromatous patients.

What are the symptoms of leprosy?

Tuberculoid leprosy symptoms are a few well-defined skin lesions that are
numb. Lepromatous leprosy symptoms are a chronically stuffy nose and many
skin lesions and nodules on both sides of the body.

How soon after exposure do symptoms appear?

It usually takes about four years for tuberculoid leprosy symptoms to appear
and about eight years for lepromatous leprosy symptoms to appear.

When and for how long is a person able to spread leprosy?

In most cases, a person will not infect others after about three months In most cases, a person will not infect others after about three months
of starting treatment.

What is the treatment for leprosy?

There are two medicines that have to be taken once a month for at least
two years for patients with lepromatous leprosy. For tuberculoid leprosy,
two medicines should be taken once a month for six months.

How can leprosy be prevented?

The best way to prevent the spread of leprosy is the early diagnosis and
treatment of people who are infected. For household contacts, immediate and
annual examination for at least five years after last contact with a person who
is infectious, is recommended.

Leprosy Polyneuritis (neuropathy)

This is actually the most common neuropathy in the world.  (However, in the US, diabetes is the most common cause of neuropathy). There is a direct invasion of the nerve by Mycobacterium leprae.  The macules or papules that appear on the skin, often lacking pigment and sensation are caused by the invasion of the nerves supplying the skin.  As the disease progresses the bacteria forms epitheliod granulomas (tuberculoid leprosy) which enlarges the nerves enough so they are palpable.  When the nerve is invaded there is obvious loss of nerve fibers resulting in numbness or weakness.  It may affect any nerve, but preferentially involves the unmyelinated fibers more so.  There is generally a loss of sensation before the onset of motor weakness.  Autonomic nerves are generally spared.  The lepromatous form of leprosy, has better preservation of nerve structures.
I hope this information is helpful for your paper.  If you need more information, write back.  I was able to find quite a bit of information in neurology textbooks and neuropathology textbooks.  Good luck.

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