Sensory Ganglionopathy in Hansen’s Disease: Report of a Patient and Review of Literature

Hansen’s neuropathy usually affects cooler parts of the body, but presentation with poly-ganglionopathy is rare. We report a patient with ganglionopathy associated with pure neuritic Hansen’s disease and discuss it in the light of the reported literature. A 42-year-old male presented with painful distal paraesthesia and ataxia for three months. His sensory nerve conduction was unrecordable. Thyroid hormones, vasculitis profile, HIV serology and hepatitis workup were normal. MRI of nerves and whole-body positron emission tomography were also normal. Slit smear examination of the affected skin after appropriate staining and microscopic examination showed the presence of AFB (M. leprae). He was treated with rifampicin, clofazimine, dapsone and prednisolone, and at six-month follow-up, he was asymptomatic. We conclude that leprosy should be considered in the differential diagnosis of sensory poly-ganglionopathy, especially in tropical countries, as it is amenably treatable.