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Arsenic poisoning can cause peripheral neuropathy. The lesion is a sensory-motor axonopathy.

  • The classic finding is a peripheral neuropathy involving sensory greater than motor neurons in a symmetrical, stocking glove distribution [Murphy et al. 1981].
  • In high-level arsenic exposures, onset of neuropathy may occur after 7 to 14 days, with intense
    • increased sweating in the distal lower extremities,
    • muscle cramps,
    • muscle tenderness,
    • numbness,
    • paresthesia, and
    • spontaneous pain [Bleecker 2007].
  • Sensory effects, particularly painful dysesthesia, occur earlier and may predominate in moderate poisoning, whereas ascending weakness and paralysis may be evident in more severe poisoning.
  • Those cases may at first seem indistinguishable from Guillain-Barré syndrome (acute inflammatory demyelinating polyneuropathy) [Donofrio et al. 1987].

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