01373nas a2200241   4500000000100000008004100001260001300042653002800055653001100083653001200094653000900106653001600115653001800131100001400149700001300163700001300176700001400189245003700203300000900240490000800249520086000257022001401117       1989                            d  c1989 Aug10aDiagnosis, Differential10aHumans10aleprosy10aMale10aMiddle Aged10aSyringomyelia1 aAchiron A1 aKramer U1 aGadoth N1 aMelamed E00a[Syringomyelic form of leprosy].  a66-80 v1173 a<p>A 60-year-old man suffered from recurrent painless burns. During his first neurological work-up, ulcers with trophic changes were noted on the dorsum of both hands. Temperature and pain sensation were decreased over the upper extremities, but touch, vibration and position sense were normal. Syringomyelia was considered, but neuroradiologic evaluation was negative. A year later he was readmitted and was found to have patchy anesthesia involving all extremities, but no distal muscle weakness or wasting; tendon reflexes were normal. Leprosy was diagnosed and confirmed by skin and nerve biopsies. This syringomyelic form of leprosy is difficult to diagnose as it often mimics intraspinal space-occupying lesions. In Israel, where leprosy is still endemic, unusual sensory disturbances, such as patchy dysesthesia, should suggest its possibility.</p>  a0017-7768