Neuroimaging in Leprosy: the nerves and beyond

Abstract Objective To elucidate the spectrum of findings on neuroimaging in leprosy with special reference to magnetic resonance imaging (MRI). Material and methods We retrospectively reviewed the neuroimaging findings on MRI in thirty-one patients with leprosy where dedicated plexus, brain and spine imaging had been performed. High resolution ultrasound of the peripheral nerves and plexus was also carried out, and the findings documented. Results Twenty-one 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 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. 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.