Pandya S S, Chulawala R G
Int J Lepr Other Mycobact Dis. 1981 Dec;49(4):398-405.
In vitro electrophysiologic and light microscopic studies were carried out on the sural nerve in six patients with non-leprous neuropathy with plantar ulceration and in six patients with various types of leprous neuropathy. In the non-leprous group (with congenital and acquired neuropathy) the abnormalities in the compound action potentials of the myelinated (large and small) fibers were usually more striking than those in the unmyelinated fibers potentials. In the leprous neuropathies, on the other hand, the three major fiber groups tended to be involved indiscriminately, the unmyelinated fiber potential being as liable to abnormality as the myelinated fiber potentials. Histologically the nerve fiber damage in the congenital neuropathies appeared to be moderate to gross involvement of the myelinated fibers without the prominent demyelination and degeneration/regeneration seen in leprosy and the other acquired neuropathies. Leprous neuropathy showed, besides fiber abnormalities, the simultaneous deleterious effects of inflammation and fibrosis. It is a matter for speculation whether disturbed conduction in the large myelinated touch-pressure mediating fibers contributes significantly to impaired pain perception (mediated by small fibers) and plantar ulceration in leprosy and other acrodystrophic neuropathies.
对6例患有足底溃疡的非麻风性神经病变患者和6例患有各种类型麻风性神经病变患者的腓肠神经进行了体外电生理和光学显微镜研究。在非麻风性组（包括先天性和后天性神经病变）中，有髓（大、小）纤维复合动作电位的异常通常比无髓纤维电位的异常更明显。另一方面，在麻风性神经病变中，三大主要纤维组往往无差别地受累，无髓纤维电位与有髓纤维电位一样容易出现异常。组织学上，先天性神经病变中的神经纤维损伤表现为有髓纤维中度至重度受累，没有麻风病和其他后天性神经病变中明显的脱髓鞘以及变性/再生现象。除了纤维异常外，麻风性神经病变还显示出炎症和纤维化的同时有害作用。在麻风病和其他肢端营养不良性神经病变中，介导触觉压力的大的有髓纤维传导障碍是否对疼痛感知受损（由小纤维介导）和足底溃疡有显著影响，这还有待推测。
