A case of neuropathy mimicking Guillain-Barré syndrome after arsenic intoxication
Perriol, M.P.; Devos, D.; Hurtevent, J.F.; Tiffreau, V.; Saulnier, F.; Destee, A.; Defebvre, L.
Revue Neurologique (Paris) 162(3): 374-377
2006
ISSN/ISBN: 0035-3787 PMID: 16585894 Document Number: 603062
Introduction. Chronic arsenic toxicity is a global health problem affecting millions of people. Acute arsenic poisoning is less frequent and it is most often lethal. Therefore, its consequences are not well known, more precisely its neurological consequences. Observation. We report a case of Guillain-Barre-like syndrome and encephalopathy after acute arsenical poisoning in a 50 year-old man. After 4 month follow-up, the improvement was slow and limited with persistent motor and proprioceptive deficits. Discussion. The most frequent neurological complication induced by acute arsenical poisoning is a distal, symmetrical, sensory, axonal polyneuropathy. Yet the clinical course and the electrophysiological findings may also suggest a Guillain-Barre like syndrome. Moreover, the chelating is not very effective on the neurological complications. Conclusion. Any discrepancies in the clinical course of a Guillain-Barre syndrome shall lead to reconsider the diagnosis. The association of gastro-intestinal disorders, skin lesions, and encephalopathy and mood disorders leads to discuss intoxication with heavy metal and more precisely with arsenic. Moreover, the chelating is not very effective on the neurological complications.