Multiple cranial nerve palsies secondary to a recurrence of Hansens disease

Description

A 31-year-old Indian man presented with drooping of the right eyelid since 1 month, slight deviation of the angle of the mouth to the right since 20 days, difficulty in swallowing (initially with regard to solids, and later on with regard to liquids) since 15 days, nasal regurgitation since 15 days and a nasal twang since 15 days. His past history was not significant, with no history of fever, weight loss, diarrhoea, swollen glands, rash, disfigurement of the hands and feet, loss of eyebrows, or any history suggestive of limb weakness, numbness or tingling. He was not on any medications. None of his parents had any health problems.

He had been previously treated for multibacillary leprosy (Hansen's disease) 3 years back and had taken treatment for 1 year for the same.

On examination, he was found to have bilateral lower motor neuron (LMN)-type glossopharyngeal and vagus nerve palsy; right-sided oculomotor nerve palsy as evidenced...

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