Leprosy, also known as Hansen's Disease, has been known since biblical times. The causative
organism Mycobacterium leprae is unique among bacteria in that it has an affinity to involve, infect
and destroy peripheral nerves, especially those of the limbs. The disability problems in Leprosy are
mainly due to the nerve trunks affected by the disease resulting in diminution or loss of sensation,
paralysis of muscles producing deformities and autonomic nerve function impairment leading to
loss of sweating, dryness and cracks in the hands and feet. The affected nerve from the initial stage
of involvement advances to the stage of damage and finally to a stage of destruction. In the stage
of initial involvement, the nerves are thickened, tender, and painful but have no loss of function.
In the subsequent stage of damage there is loss of sweating and sensibility, muscle weakness or
complete paralysis. These two stages of nerve involvement and damage are amenable to prompt
and adequate treatment by multi drug therapy (MDT) and steroids and recovery of lost nerve
functions in possible. In the subsequent stage of nerve destruction, the involved nerve is
completely damaged and cannot recover function to any useful level with all available treatment.
This stage is diagnosed when the nerve has been completely paralyzed for at least one year.
Leprosy involves three kinds of peripheral nerves. They are (1) dermal nerves, which are fine
nerves in the skin; (2) cutaneous nerves, which are thicker nerves that are palpable under the skin
and (3) major nerve trunk, which are large nerves of the limbs.http://repub.eur.nl/res/pub/20520/100604_Rath%2C%20Santosh.pdf
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