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Updated: Jun 16, 2026
07:42
Nerve Excitability Assessment in Chemotherapy-induced Neurotoxicity
Published on: April 26, 2012
Arsenical peripheral neuropathy.
Liberty Mathew1, Allister Vale, Jane E Adcock
1Department of Neurology, West Wing, John Radcliffe Hospital, Oxford, UK.
Practical Neurology
|February 5, 2010
Summary
A traveler developed severe sensorimotor neuropathy and skin rash after visiting Goa. Arsenic poisoning was diagnosed via urine tests and treated with chelation therapy, with deliberate poisoning suspected.
Area of Science:
- Toxicology
- Neurology
- Dermatology
Background:
- A 49-year-old man presented with a multi-week history of gastrointestinal distress, weight loss, a desquamating skin rash, and progressive sensorimotor neuropathy.
- Symptoms developed after a 3-month stay in Goa, India.
Observation:
- A 49-year-old man presented with vomiting, weight loss, skin rash, and painful sensorimotor neuropathy after 3 months in Goa.
- Clinical examination revealed mild normocytic anemia and lymphopenia.
- Nerve conduction studies and sural nerve biopsy confirmed a severe axonal large fiber sensorimotor neuropathy.
Findings:
- Urine arsenic concentration was significantly elevated at 300 microg/l, confirming arsenic poisoning.
- Symptoms largely resolved after leaving Goa, except for persistent severe neuropathic symptoms.
- The patient responded well to chelation therapy.
Implications:
- This case highlights the importance of considering environmental and toxicological causes, such as arsenic poisoning, in patients with unexplained neurological and dermatological symptoms after international travel.
- Early diagnosis and intervention, including chelation therapy, are vital for managing arsenic toxicity.
- Public health awareness regarding arsenic exposure risks in certain travel destinations is warranted.
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