Dikhyaa Mohanty 
A “hidden” type of leprosy can silently impact the brain and spinal cord, according to a new study released Monday by experts at AIIMS Bhubaneswar. Pure neuritic leprosy (PNL), a lesser-known form of leprosy, can cause serious harm without causing any outward signs of skin abnormalities, despite the fact that leprosy is an old illness that frequently results in deformity. This “hidden” kind of leprosy is frequently undetected and mostly affects peripheral nerves. Treatment delays and even disability may result from an early diagnosis. The study questions the widely held belief that PNL is only a peripheral nerve disease. It was published in the medical journal Acta Neurologica Belgica.
It emphasizes how crucial it is to evaluate central nervous system involvement in order to recognize and treat the condition early on. This discovery may result in novel medications and treatments that improve results. According to Dr. Sanjeev Kumar Bhoi, Head of the Neurology Department at AIIMS Bhubaneswar, the majority of PNL patients show subclinical involvement of the central nervous system.
“This means the disease can silently affect the brain and spinal cord even without causing noticeable skin lesions — a hallmark of leprosy,” the doctor explained.
The new finding will have significant implications for leprosy diagnosis and management. It will also pave the way for earlier diagnosis and targeted interventions.
“Our study shows that PNL can subtly affect the central nervous system. Such leprosy cases are often left undiagnosed due to the absence of skin-related symptoms,” Bhoi said. He stressed the need to test “both peripheral and central nervous involvement” to accelerate early detection of PNL, “allowing for treatment to reduce disability risks.”
The research, which was funded by the Odisha government, examined 76 individuals who were thought to have PNL. The scientists used nerve samples to confirm the diagnosis in 49 individuals, ranging in age from 14 to 72. According to the study, the most prevalent symptoms were unilateral foot drop and claw hand, and the majority of patients were men. The group also proposed novel methods for diagnosing PNL, including examinations of the central nervous system and nerve conduction studies. Patients experiencing nerve-related complaints, such as muscular weakness or sensory loss without skin lesions, should have nerve conduction studies performed. According to the study, tests such as VEP (for visual nerve networks), SSEP (for sensory pathways), and BAEP (for auditory pathways) should be taken into consideration for a more thorough diagnosis.
