Pure neural tuberculoid leprosy.

Applied Electrophysiology in Nerve and Muscle Disease [Abridged]

“…It seems, therefore, that one can to some extent predict the nature of the underlying pathology from nerve conduction studies, and in our own clinic we accept motor velocities which are reduced by more than 40% as likely to indicate the presence of segmental demyelination. On this basis one might suggest that both leprosy and sarcoid neuropathy will turn out to be examples of segmental demyelination (Jopling & Morgan-Hughes 1965, Willison 1966, although as yet we cannot provide histological proof of this.…”

Pathology of the peripheral nerves in leprosy: report of a case

“…The latter type of Wallerian-like destruction has been illustrated many times since the accounts of Virchow (1864), Gerlach (1891), and Lie (1894). The former type of disorder, a demyelinating neuropathy, has been suspected on clinical grounds only because of the transient nature and rapid reversibility of some lesions (Browne, 1965), and the very slow conduction velocities and other electrophysiological observations made in a few cases (for example, Jopling and Morgan Hughes, 1965;Rosenberg and Lovelace, 1968). However, as discussed at length by Lumsden (1964), the exact pathological nature of the nerve lesions of leprosy has remained uncertain.…”

“…The histological features of the affected nerves as displayed by conventional techniques (Virchow, 1864;Lie, 1894;Krucke, 1955;Khanolkar, 1964) have shown leprosy bacilli in nerve trunks, granulomatous inflammation, and varying degrees of damage to myelin sheaths and axis cylinders. Certain clinical features and the results of electrophysiological tests of nerve conduction (Jopling and Morgan Hughes, 1965;Rosenberg and Lovelace, 1968) have been interpreted as evidence for the occurrence at some stage of segmental demyelination, as well as of total nerve fibre degeneration.…”

Leprosy and the peripheral nervous system: Basic and clinical aspects

“…In tuberculoid leprosy, enlarged nerves and trunks are seen usually within the proximity of the skin lesion. Nerve biopsies reveal significant destruction of the nerve architecture with the presence of granulomas in the nerves containing epitheloid cells and giant cells, both Langhans' and foreign‐body giant cells with scattered mononuclear infiltration 73, 162. The granulomas extend from the perineurium to the endoneurium and sometimes also involve the epineurium.…”