PT  - JOURNAL ARTICLE
AU  - Liberty Mathew
AU  - Allister Vale
AU  - Jane E Adcock
TI  - Arsenical peripheral neuropathy
AID  - 10.1136/jnnp.2009.201830
DP  - 2010 Feb 01
TA  - Practical Neurology
PG  - 34--38
VI  - 10
IP  - 1
4099  - http://pn.bmj.com/content/10/1/34.short
4100  - http://pn.bmj.com/content/10/1/34.full
SO  - Pract Neurol2010 Feb 01; 10
AB  - A 49-year-old white man returned urgently to the UK after spending 3 months in Goa. He had a several week history of vomiting, weight loss, a widespread desquamating skin rash, and symptoms and signs of a progressive painful sensorimotor neuropathy. He had a mild normocytic anaemia and lymphopenia. Nerve conduction studies revealed a severe predominantly axonal large fibre sensorimotor neuropathy, confirmed on subsequent sural nerve biopsy. Once he had left Goa most of his symptoms started to rapidly settle although the neuropathic symptoms remained severe. Arsenic poisoning was suspected. A spot urine arsenic concentration was 300 μg/l, confirming the diagnosis. He was treated with chelation therapy. Deliberate arsenic poisoning was highly likely.