Clinical, neurophysiological and histopathological profile of patients with neuropathic pain secondary to leprosy from a referral service in southeastern Brazil

Objectives: To describe the clinical, neurophysiological and histopathological profile of patients with leprosy neuropathy and neuropathic pain from a referral service for leprosy in southeastern Brazil.

Results: Among the data analyzed, we found a statistically significant correlation between the duration of leprosy and the duration of associated neuropathic pain, and also between the age of the patient and the number of nerves affected in nerve conduction studies. We also found a statistically significant inverse relationship between the duration of neuropathic pain and the score in the SF-36 “general health” domain, suggesting a worse quality of life among these patients. We identified the presence of inflammatory infiltrate in the nerve biopsy of most patients with leprosy reaction, and also worse scores in the SF-36 “pain” domain among these patients; these data together suggest that the presence of leprosy reaction is a risk factor for the occurrence of neuropathic pain. Treatment of leprosy with a multidrug regimen does not prevent the occurrence of neuropathic pain or interrupt the development of neuropathy, data reinforced in the present study in which the majority of patients had undergone previous leprosy treatment and another portion of patients received treatment during the study.

Conclusion: We conclude that knowledge about risk factors and characteristics associated with neuropathic pain in leprosy neuropathy is of potential importance to outline strategies for early identification and treatment of this manifestation, in addition to demonstrating that neuropathic pain negatively impacts the quality of life, which further reinforces the importance of this topic in neurologic practice.