Leprosy Training Module for Medical Officers

( C ) Nerve Examination :
Remember the cardinal sign :
Involvement of peripheral nerves, as demonstrated by
definite thickening with loss of sensation and
weakness of the muscles of hands, feet or face.
Principles of Nerve Examination :
Examination of nerves in all the patients is very important for
prevention of deformity. This involves two aspects :
1. Palpation of Nerves for thickening or tenderness.
2. Assessment of Nerve function.
1. Palpation of Nerves for thickening or tenderness :
Nerve damage, mainly to peripheral nerve trunks, constitutes another feature
of Leprosy. There may be loss of sensation in the skin and the weakness of
muscles supplied by the affected nerve. In the absence of these signs, nerve
thickening by itself, without sensory loss, and / or muscle weakness is often not
a reliable sign of Leprosy.
Remember :
In a healthy subject, most peripheral nerves are palpable.
• When palpating the nerves, you should look for thickening and / or
tenderness.
• When palpating the nerves, the patient should be properly positioned. The
examiner should also be positioned correctly.
• Always compare both sides to assess thickness.
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