Spinal Hansens with Pseudo Syringomyelitic Form

Spinal cord involvement is rare in leprosy but not unknown. We document an interesting case of a 56 year old male presented with progressive weakness of all four limbs with gross wasting of limb muscles and multiple painless trophic ulcers over the hands and legs. Examination revealed pan sensory loss in glove and stock distribution with suspended sensory loss for pain and temperature over the chest. Areflexia was noted in the upper limbs and brisk reflexes were present in the lower limbs. Generalized peripheral nerve thickening was noted. Leprosy was diagnosed and confirmed by nerve biopsy. Other causes of intra spinal lesions were excluded. This pseudo syringomyelitic from of leprosy is difficult to diagnose as it often mimics intra medullary spinal lesions.