Figure 18.4 The main nerves that may be affected in a person with leprosy.
The examination of the nerves is an important part of examination of a person suspected of leprosy. The two most commonly affected nerves in leprosy patients are the ulnar and peroneal nerves, and can be felt quite easily (see Figure 18.4). Palpate ('feel') the nerves shown in Figure 18.4, starting from the head to the feet; do so following the technique described in Box 18.3 and the photos in Figure 18.5.
Box 18.3 Palpating the nerves in a person with suspected leprosy
- Peripheral nerves are examined for enlargement or thickening and for tenderness
- When palpating a nerve always use two or three fingers (see Figure 18.5)
- The nerve should be rolled over the surface of the underlying bone
- The same nerve on the left and right sides of the body must always be compared.
Figure 18.5 Palpating (a) and (b) the ulnar nerve, and (c) the peroneal nerve. (Source: ILEP, 2001, as in Figure 18.3)